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"disqusTitle": "As Surgery Centers Boom, Patients Are Paying With Their Lives",
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"content": "\u003cp>The surgery went fine. Her doctors left for the day. Four hours later, Paulina Tam started gasping for air.\u003c/p>\n\u003cp>Internal bleeding was cutting off her windpipe, a well-known complication of the spine surgery she had undergone.\u003c/p>\n\u003cp>But a Medicare inspection report describing the event says that nobody who remained on duty that evening at the Northern California surgery center knew what to do.\u003c/p>\n\u003cp>In desperation, a nurse did something that would not happen in a hospital.\u003c/p>\n\u003cp>She dialed 911.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>By the time an ambulance delivered Tam to the emergency room, the 58-year-old mother of three was lifeless, according to the report.\u003c/p>\n\u003cp>If Tam had been operated on at a hospital, a few simple steps could have saved her life.\u003c/p>\n\u003cp>But like hundreds of thousands of other patients each year, Tam went to one of the nation’s 5,600-plus surgery centers.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Some surgery centers risk patient lives by skimping on training or lifesaving equipment.'\u003c/aside>\n\u003cp>Such centers started nearly 50 years ago as low-cost alternatives for minor surgeries. They now outnumber hospitals as federal regulators have signed off on an ever-widening array of outpatient procedures in an effort to cut federal health care costs.\u003c/p>\n\u003cp>Thousands of times each year, these centers call 911 as patients experience complications ranging from minor to fatal. Yet no one knows how many people die as a result, because no national authority tracks the tragic outcomes. An investigation by Kaiser Health News and the USA TODAY Network has discovered that more than 260 patients have died since 2013 after in-and-out procedures at surgery centers across the country. Dozens — some as young as 2 — have perished after routine operations, such as colonoscopies and tonsillectomies.\u003c/p>\n\u003cp>Reporters examined autopsy records, legal filings and more than 12,000 state and Medicare inspection records, and interviewed dozens of doctors, health policy experts and patients throughout the industry, in the most extensive examination of these records to date.\u003c/p>\n\u003cp>The investigation revealed:\u003c/p>\n\u003cp>Surgery centers have steadily expanded their business by taking on increasingly risky surgeries. At least 14 patients have died after complex spinal surgeries like those that federal regulators at Medicare recently approved for surgery centers. Even as the risks of doing such surgeries off a hospital campus can be great, so is the reward. Doctors who own a share of the center can earn their own fee and a cut of the facility’s fee, a meaningful sum for operations that can cost $100,000 or more.\u003c/p>\n\u003cp>To protect patients, Medicare requires surgery centers to line up a local hospital to take their patients when emergencies arise. In rural areas, centers can be 15 or more miles away. Even when the hospital is close, 20 to 30 minutes can pass between a 911 call and arrival at an ER.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The money overshadows everything.'\u003ccite>Dr. Larry Teuber\u003c/cite>\u003c/aside>\n\u003cp>Some surgery centers are accused of overlooking high-risk health problems and treat patients who experts say should be operated on only in hospitals, if at all. At least 25 people with underlying medical conditions have left surgery centers and died within minutes or days. They include an Ohio woman with out-of-control blood pressure, a 49-year-old West Virginia man awaiting a heart transplant and several children with sleep apnea.\u003c/p>\n\u003cp>Some surgery centers risk patient lives by skimping on training or lifesaving equipment. Others have sent patients home before they were fully recovered. On their drives home, shocked family members in Arkansas, Oklahoma and Georgia discovered their loved ones were not asleep but on the verge of death. Surgery centers have been criticized in cases where staff didn’t have the tools to open a difficult airway or skills to save a patient from bleeding to death.\u003c/p>\n\u003cp>Most operations done in surgery centers go off without a hitch. And surgery carries risk, no matter where it’s done. Some centers have state-of-the-art equipment and highly trained staff that are better prepared to handle emergencies.\u003c/p>\n\u003cp>But Kaiser Health News and the USA TODAY Network found more than a dozen cases where the absence of trained staff or emergency equipment appears to have put patients in peril.\u003c/p>\n\u003cp>\u003cimg class=\"size-medium wp-image-436004 alignleft\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/depression-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\">And in cases similar to Tam’s, upper-spine surgery patients have been sent home too soon, with the risk of suffocation looming.\u003c/p>\n\u003cp>In 2008, a 35-year-old Oregon father of three struggled for air, pounding the car roof in frustration while his wife sped him to a hospital. A Dallas man collapsed in his father’s arms waiting for an ambulance in 2011. Another Oregon man began to suffocate in his living room the night of his upper-spine surgery in 2014. A San Diego man gasped “like a fish,” his wife recalled, as they waited for an ambulance on April 28, 2016.\u003c/p>\n\u003cp>None of them survived.\u003c/p>\n\u003cp>Spinal surgery patient McArthur Roberson, 60, lost more than a quart of blood during the operation and struggled to breathe after surgery, his family claimed in a lawsuit. He died on the way home.\u003c/p>\n\u003cp>If he “had been observed in a hospital overnight,” said Dr. Daniel Silcox, an Atlanta spine surgeon and expert for the family in their lawsuit, “his death would not have occurred.”\u003c/p>\n\u003cp>The surgery center denied wrongdoing in the case, which reached a confidential settlement in 2017.\u003c/p>\n\u003cp>Many in the health care field — from doctors to private insurance companies to Medicare — have dismissed the mounting deaths as medical anomalies beyond the control of physicians.[contextly_sidebar id=\"yGkONjf2A21M8TI9B7IbDLgIYlcEIWeB\"]\u003c/p>\n\u003cp>USA TODAY Network and KHN reporters contacted 24 doctors and surgery center administrators about patient deaths and none would answer questions about what went wrong, citing patient privacy laws, or referring reporters to attorneys. Responding to lawsuits around the nation, surgery centers have argued that fatal complications were among the known outcomes of such surgeries. Two centers blamed patients for negligence in their own demise.\u003c/p>\n\u003cp>Bill Prentice, chief executive of the Ambulatory Surgery Center Association, declined to speak about individual cases but said he has seen no data proving surgery centers are less safe than hospitals.\u003c/p>\n\u003cp>“There is nothing distinct or different about the surgery center model that makes the provision of health care any more dangerous than anywhere else,” Prentice said. “The human body is a mysterious thing, and a patient that has met every possible protocol can walk in that day and still have something unimaginable happen to them that has nothing to do with the care that’s being provided.”\u003c/p>\n\u003cp>However, Dr. Kenneth Rothfield, board member of the Physician-Patient Alliance for Health & Safety, said many surgery centers and physicians push the envelope on how much can be done in outpatient centers.[contextly_sidebar id=\"nTpXhL5UY41KmxUslysOyQnfIH1Es3fu\"]\u003c/p>\n\u003cp>“It’s important to realize that surgery centers are not hospitals,” he said. “They have different resources, different equipment.”\u003c/p>\n\u003cp>The explosive growth of surgery centers — which receive $4.1 billion a year from Medicare — has taken place under circumstances some medical experts consider unseemly.\u003c/p>\n\u003cp>Federal law allows surgery center doctors — unlike others — to steer patients to facilities they own, rather than the full-service hospital down the street. In some cases, doing so could increase the risk to a patient, but double a physician’s profits.\u003c/p>\n\u003cp>Prentice said physician ownership of surgery centers is a good thing.\u003c/p>\n\u003cp>“The physicians who practice there are responsible for everything that happens in that surgery center from the moment the patient walks out of their car in the parking lot to the moment they leave,” he said.\u003c/p>\n\u003cp>But several studies have shown that surgery center doctors who are owners perform operations more frequently. And in lawsuits across the country, surgery center doctors have been accused of taking risks with patients.\u003c/p>\n\u003cp>Even some who’ve made their living in the surgery center industry have expressed concerns. Dr. Larry Teuber, a South Dakota neurosurgeon who worked as an executive in the surgery center industry for 22 years, said he has watched surgery center owners take on increasingly complex — and lucrative — orthopedic and spinal surgeries, undercutting a nearby hospital’s profits for their own gain.\u003c/p>\n\u003cp>“When you’re making money doing [complex surgeries] you get on a slippery ethical slope,” Teuber said. “The money overshadows everything.”\u003c/p>\n\u003cp>\u003cstrong>The History\u003c/strong>\u003c/p>\n\u003cp>The first surgery center in the U.S. opened in Phoenix in 1970, a place “squeezed between neighborhood shops and a Baptist church,” where, for $90, a child could receive an incision to relieve pressure on the inner ear, The Arizona Republic reported at the time.\u003c/p>\n\u003cp>The pioneering doctors, John Ford and Wallace Reed, didn’t see why patients needed to be hospitalized for such minor surgeries.\u003c/p>\n\u003cp>Taking the procedures out of hospitals reduced the cost for patients and insurers because surgery centers don’t require the same level of staffing or lifesaving equipment.\u003c/p>\n\u003cp>Medicare helped drive the expansion of surgery centers when it began paying for procedures in 1982.\u003c/p>\n\u003cp>Then in 1993, Congress encouraged doctors to open surgery centers by exempting them from the second Stark Law, which prevents doctors from steering patients to other businesses they own.\u003c/p>\n\u003cfigure id=\"attachment_440038\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-440038\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/iStock-638540542-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-1920x1281.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-1180x788.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-960x641.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Surgeons passing scissors to each other \u003ccite>(gpointstudio/IStock)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Doctors-turned-entrepreneurs drove early growth, urging their patients to give the centers a chance. Seeing lucrative elective surgeries moving away, hospitals increasingly bought centers of their own. Last year, insurance giant UnitedHealth Group spent $2.3 billion buying a national surgery center chain.\u003c/p>\n\u003cp>The centers have been popular with patients, who enjoy the convenience and personalized care. Doctors say they like the ease of planning operations without unexpected trauma surgeries upending the schedule. And surgery centers have thrived even as hospitals have battled to contain the spread of infections.\u003c/p>\n\u003cp>Today, there are 5,616 Medicare-certified centers. The expansion has come despite lingering safety concerns. In 2007, Medicare noted that surgery centers “have neither patient safety standards consistent with those in place for hospitals, nor are they required to have the trained staff and equipment needed to provide the breadth of intensity of care. …” Some procedures are “unsafe” to be handled at surgery centers, the report concluded.[contextly_sidebar id=\"Oh8vuiOByjR9KfyFdmF17zW0bJKBCpIa\"]\u003c/p>\n\u003cp>Medicare advised the centers to transfer patients to hospitals when emergencies arise. Only a third of surgery centers participate in a voluntary effort to report how often that happens. They sent at least 7,000 patients to the hospital in the year that ended in September 2017, a KHN analysis of surgery center industry data shows. Not all survive the trip.\u003c/p>\n\u003cp>They include James Long, 56, who had no pulse when an ambulance came to the Colorado surgery center where he’d undergone more than five hours of lower-spine surgery in 2014, according to the center’s medical records provided to the family’s attorney.\u003c/p>\n\u003cp>The state reviewed the case and cited no deficiencies. Jen Kenitzer, the Minimally Invasive Spine Institute administrator, said the center has “extensive procedures in place to respond quickly and appropriately” in emergencies.\u003c/p>\n\u003cp>Yet Long’s loved ones remain troubled by the case.\u003c/p>\n\u003cp>“In the 21st century in the USA, a doctor doing a surgery on a patient has to call 911?” said Robin Long, his ex-wife, who did not sue the center. “Give me a break. … It’s just absolutely ignorant.”\u003c/p>\n\u003cp>\u003cstrong>Preparation Under Par\u003c/strong>\u003c/p>\n\u003cp>Patients enter hospitals with heart attacks, gunshot wounds and traumatic injuries. There, doctors and nurses become skilled at saving lives in emergencies.\u003c/p>\n\u003cp>Doctors in surgery centers may excel at the procedures they perform most often. But the centers aren’t always prepared and sometimes struggle in a crisis, according to a review of Medicare records and more than 70 lawsuits.\u003c/p>\n\u003cp>Health inspectors working on behalf of Medicare have discovered 230 lapses in rescue equipment or training regulations at surgery centers since 2015.\u003c/p>\n\u003cp>A center in California had empty oxygen tanks. One operating on children in Arkansas didn’t have a pediatric tracheotomy set to restore breathing; another lacked pediatric defibrillator pads to shock hearts back into rhythm.[contextly_sidebar id=\"xgSiNPNFJJTyDToF3ZdazMurAQ4SAxDl\"]\u003c/p>\n\u003cp>In an ongoing lawsuit against her and the center, anesthesiologist Dr. Yoori Yim testified that she came up empty-handed on Dec. 23, 2015, when grappling to find the right-sized airway tube to save a patient who had stopped breathing.\u003c/p>\n\u003cp>Rekhaben Shah, 67, had come to Oak Tree Surgery Center in Edison, N.J., for a simple colonoscopy.\u003c/p>\n\u003cp>Yim tried a variety of methods to help Shah breathe, with limited success. From the moment Shah stopped breathing on the operating table, 33 minutes passed before a paramedic effectively inserted a breathing tube, according to medical and EMS records.\u003c/p>\n\u003cp>Paramedics responding to the center’s 911 call had to use a video GlideScope to see inside the patient’s throat, equipment the surgery center didn’t have, court testimony says.\u003c/p>\n\u003cp>By then it was too late. Shah was removed from life support at a nearby hospital on Christmas Day.\u003c/p>\n\u003cp>Neither Yim nor the center returned calls for comment. In court records, an expert for the surgery center said Shah’s airway was obstructed and it was cleared around the time the paramedics arrived. He said the GlideScope is not required in New Jersey, nor would it likely have made a difference. An expert for Yim, however, said her actions were appropriate and if a GlideScope had been at the center, “we would probably not be discussing this case at all.”\u003c/p>\n\u003cp>When emergency crews arrive, surgery centers are not always prepared to receive them.\u003c/p>\n\u003cp>In Yim’s case, paramedics testified that she refused to move away from Shah and allow them to attempt lifesaving measures.\u003c/p>\n\u003cp>In Florida, paramedics who rushed to a surgery center after its usual operating hours hit a locked door while a patient inside gasped for breath. The 55-year-old remains in a vegetative state.\u003c/p>\n\u003cp>In 2016, paramedics arrived at West Lakes Surgery Center in Iowa as staff tried to revive 12-year-old Reuben Van Veldhuizen after he experienced complications during a tonsillectomy, according to a Medicare inspection report.[contextly_sidebar id=\"iy3S1eIYgobood9l19mbUsM4p7gpgSwB\"]\u003c/p>\n\u003cp>One paramedic told state inspectors she had to ask who was in charge of the resuscitation efforts. No one replied, the inspection report says.\u003c/p>\n\u003cp>The boy made it to the hospital 37 minutes after the surgery center staff called 911. There, he was pronounced dead.\u003c/p>\n\u003cp>The family filed suit, alleging that the center and anesthesiologist erred in giving the boy an anesthetic that carries a warning about cardiac arrest risk in young boys.\u003c/p>\n\u003cp>In court records responding to the lawsuit, the surgery center and anesthesiologist said Reuben’s death was a result of “pre-existing conditions, acts of others, or conditions over which (Defendants) had no control or responsibility.”[contextly_sidebar id=\"VI9AZs5TNC51Y7UgdHVDpUXpakSmw0kK\"]\u003c/p>\n\u003cp>Yet lawyers who sue the centers and scrutinize their internal records say they often see deadly delays in care.\u003c/p>\n\u003cp>Pedro Maldonado, 59, went to Ambulatory Care Center in New Jersey to have his upper digestive tract scoped. He was discovered unresponsive 10 minutes after the seven-minute procedure, according to his widow’s lawsuit.\u003c/p>\n\u003cp>It took surgery center staff 25 more minutes to start CPR, according to a lawsuit that Philadelphia attorney Glenn Ellis filed on behalf of Maldonado’s widow. Twenty-seven more minutes passed before Maldonado was wheeled into an ER, the widow’s ongoing suit alleges. Maldonado never regained consciousness.\u003c/p>\n\u003cp>Reached by phone, a center administrator declined to comment. In a legal filing, the center denied claims of wrongdoing.\u003c/p>\n\u003cp>“At a hospital, doctors and nurses … know how they are going to respond,” Ellis said. “These guys at the surgery centers are walking on a tightrope with no safety net.”\u003c/p>\n\u003cp>\u003cstrong>Conveyor Belt Of Care\u003c/strong>\u003c/p>\n\u003cp>While the thrum of a hospital continues through the night, some surgery center doctors keep banker’s hours. That means patients whose surgeries end later in the day are sometimes left in the care of one or two nurses for up to 23-hour stays. Some patients have been sent home to grapple with complications on their own.\u003c/p>\n\u003cp>Sondra Wallace went to the Surgery Center of Oklahoma in early 2017 for a sinus procedure.\u003c/p>\n\u003cp>After the procedure, doctors saw her blood-oxygen level sinking. They realized she had had a reaction to the anesthesia and at 2 p.m. gave her a drug to reverse the effects, an ongoing lawsuit filed by her husband says.[contextly_sidebar id=\"9BEvkmOwOv0XN6LAFVyarPQ0ptuu9CWR\"]\u003c/p>\n\u003cp>Then, an hour later, they sent her home with her husband, Larry, the lawsuit says.\u003c/p>\n\u003cp>It was 3 p.m. on the Friday before Presidents Day weekend.\u003c/p>\n\u003cp>“I just think they wanted to start their three-day weekend,” said daughter Casey Podoll.\u003c/p>\n\u003cp>Larry Wallace alleges in the suit that the center gave him no hint that Sondra had a reaction to the anesthesia.\u003c/p>\n\u003cp>So, Wallace thought nothing of her napping in the back seat as he drove for more than two hours through Oklahoma pastures on his way home. When he arrived, he discovered his wife cold in the back seat. She was pronounced dead at Jackson County Memorial Hospital at 6:30 p.m. that day.\u003c/p>\n\u003cp>“They didn’t give any indication … that there were any red flags whatsoever,” Podoll said.\u003c/p>\n\u003cp>Craig Buchan, attorney for the Surgery Center of Oklahoma, said Wallace met discharge criteria and her cause of death has not been determined. He said the center did not close any earlier “than often occurs after the last patient is discharged.”\u003c/p>\n\u003cp>Cecilia Aldridge said she also felt as if the staff at a surgery center was rushing her out the door, after her 2-year-old daughter’s tonsil surgery in Arkansas in 2015.\u003c/p>\n\u003cp>A lawsuit filed by the parents said the surgery center “discharged Abbygail too early because a snow storm was moving into the area.”\u003c/p>\n\u003cp>Abbygail turned blue in the car on the way home. Her mother said she raced into an emergency room, shouting for help, her toddler in her arms.\u003c/p>\n\u003cp>“She never woke up,” Aldridge said tearfully in an interview.\u003c/p>\n\u003cp>Abbygail’s parents now question whether the surgery center ever should have been willing to treat their daughter.\u003c/p>\n\u003cp>\u003cstrong>Risky Patients\u003c/strong>\u003c/p>\n\u003cp>Because surgery centers have less safety equipment and staffing than hospitals, industry leaders stress the importance of selecting patients healthy enough to fare well. Their predictions, though, are not always correct.\u003c/p>\n\u003cp>Abbygail, who loved her hand-me-down blanket and the film “Frozen,” had sleep apnea, an irregular heartbeat and was very heavy for her age, according to the lawsuit.\u003c/p>\n\u003cp>Sleep apnea increases the risk of serious complications in surgery and the night after, medical research shows. Given her condition, Abbygail “should have been admitted [to a hospital] and monitored post-procedure,” said Dr. Charles Cote, a retired Harvard pediatric anesthesiology professor who was not involved in the family’s lawsuit.[contextly_sidebar id=\"gjUHM4nwVAL7lCCCNoVNHgGksiZfeuxR\"]\u003c/p>\n\u003cp>The lawsuit says Abbygail’s risk factors “were documented and known by the Defendants,” including the doctor. It said the toddler should have been operated on “in an inpatient setting under hospital care and monitored overnight.”\u003c/p>\n\u003cp>Dr. Michael Marsh performed Abbygail’s tonsillectomy at Executive Park Surgery Center in Fort Smith, Ark.\u003c/p>\n\u003cp>The surgery center’s lawyer declined to comment. The doctor’s lawyer did not return email and voice messages. In court documents responding to the lawsuit, Marsh and the center denied wrongdoing.\u003c/p>\n\u003cp>In the court filing, Marsh said the toddler’s injuries were “the natural progression” of her illness. Executive Park Surgery Center said in a court filing that “no action on their part … was a proximate cause of any damages or injury.” The case was settled.\u003c/p>\n\u003cp>In at least 25 cases, surgery centers opened their doors to ailing and fragile patients who died after simple procedures, such as tonsillectomies, retinal repairs or colonoscopies, KHN and USA TODAY Network found.\u003c/p>\n\u003cp>Medicare asks surgery centers to assess each patient’s risk, but inspectors flagged 122 surgery centers in 2015 and 2016 alone for lapses in risk assessments. Some centers failed to gauge risk at all. Others overlooked their own policies.\u003c/p>\n\u003cp>Doctors can use an anesthesia risk assessment to screen out fragile patients — healthy patients get a score of 1, and a score of 5 means a person is nearly dead.\u003c/p>\n\u003cp>A few states, including Pennsylvania and Rhode Island, bar certain surgery centers from operating on patients with an anesthesia risk score of 4. But most states don’t go that far. They leave such decisions up to doctors.\u003c/p>\n\u003cp>And some of those decisions have been cited in tragic outcomes. Sabino Sifuentes, 74, had survived triple-bypass surgery. But on March 23, 2015, nine minutes after the start of anesthesia for an eye procedure, he became unresponsive, never to be revived, according to a Medicare inspection report. A nurse anesthetist who reviewed the case at Eye-Q Vision Care’s surgery center in Fresno, Calif., told state health inspectors that Sifuentes should have been given a risk score of 4 and his care was “completely mismanaged,” the inspection report says.\u003c/p>\n\u003cp>In response to the family’s lawsuit, the surgery center said Sifuentes’ injury was caused by his own negligence and others’.\u003c/p>\n\u003cp>Five other patients with the same risk score died after routine procedures at surgery centers across the U.S.\u003c/p>\n\u003cp>\u003cstrong>A Widening Niche\u003c/strong>\u003c/p>\n\u003cp>Such tragedies rarely find their way into the discussion when Medicare decides whether to approve new procedures at surgery centers.\u003c/p>\n\u003cp>Take spinal surgery.\u003c/p>\n\u003cp>Until 2015, Medicare wouldn’t pay for it at surgery centers. Then, the industry’s trade association urged the agency to make the change, and encouraged a letter-writing campaign from surgery centers across the nation.\u003c/p>\n\u003cp>Letter writers included Dr. Alan Villavicencio, a Colorado surgeon who said he’d been doing such surgeries for 12 years and found that his patients “appreciate the convenience and cost savings.” He did not mention that James Long, 56, had died three weeks earlier at a Lafayette, Colo., surgery center where he is an owner, a review of Colorado health department and medical board records shows.\u003c/p>\n\u003cp>United Surgical Partners International, a surgery center chain, also weighed in urging even more procedures to be approved, not mentioning a patient death hours after a spine surgery at one of its affiliate centers several months before, according to court records and securities filings. The chain said in a statement that it stands behind its comments in support of the proposal.[contextly_sidebar id=\"VpVDiD85oVGnFVcTHpIcD2xozEou9ew9\"]\u003c/p>\n\u003cp>Such letters carry weight with Medicare, which approves procedures to be done in surgery centers based on the invasiveness and complexity of the surgery and on input from stakeholders.\u003c/p>\n\u003cp>Robert Beatty-Walters, a Portland, Ore., attorney who has represented the families of three people who died after surgery center spine procedures, said Medicare’s decision-making process is not even-handed.\u003c/p>\n\u003cp>“The stakeholders — they call them — during these regulatory proceedings are the profit-makers, not the people who are being provided the service,” he said. “The spine centers just want to have more people come. They make more money. I hate to be that cynical about it, but that’s just what I’ve seen.”\u003c/p>\n\u003cp>Medicare approved 10 spine-surgery codes to be billed at surgery centers starting in 2015 and added more spinal procedures for 2017. A Medicare spokesman denied a request for a telephone interview. In an email, a spokeswoman said Medicare opened the spine proposal to the public and received no comments suggesting the procedures would pose a threat to Medicare patients. She said the final decision about where a patient will have surgery is up to a doctor and patient.\u003c/p>\n\u003cp>By 2017, at least 14 patients had died soon after spine operations at surgery centers, according to the KHN/USA TODAY Network investigation.\u003c/p>\n\u003cp>The 14 spine-surgery deaths have gleaned little recognition in the industry or beyond. Only one made headlines in local newspapers. The rest are documented in places like the Macon, Ga., courthouse or in obscure regulatory reports. And there may be far more because some states, including New York, Illinois and Florida, disclose no details about surgery center deaths.\u003c/p>\n\u003cp>Paulina Tam’s death at Fremont Surgery Center was a tragic example. At 58, the mother of three had finished careers as a nurse and an educator. Next, she planned to travel the world with her husband of 32 years.\u003c/p>\n\u003cp>“She was the driving force of the family, the spirit I guess,” said her son, Eric Tam, a doctor in New York City, said. “We didn’t expect the worst to happen.”\u003c/p>\n\u003cp>The care she received at the center is documented in court records, EMS reports and a Medicare inspection report that concluded that the center “failed to provide a safe environment for surgery.”\u003c/p>\n\u003cp>Tam’s doctor scheduled her for a procedure to replace two discs in her upper spine on April 7, 2014. Pain from a car crash had bothered her for years. Any such surgery — entering the front of the neck to address pain in the spine — comes with a risk of suffocation, according to the Medicare inspection report.\u003c/p>\n\u003cp>Yet, with her surgeon and anesthesiologist already gone, the only doctor on-site was a digestive health specialist, the inspection report shows. About four hours after her procedure, Tam told a nurse that her surgical collar felt too tight. Then, that she couldn’t breathe.\u003c/p>\n\u003cp>The nurse called a “code blue” just after 6:30 p.m., records say.\u003c/p>\n\u003cp>Medical experts say the first step in helping such patients is removing the surgical staples so the pooled blood can disperse, allowing the patient to breathe.\u003c/p>\n\u003cp>In Tam’s case, staff repeatedly tried and failed to insert a breathing tube through her mouth and into her airway, the inspection report shows. A last-ditch remedy would have been to punch a hole through the front of her throat to restore breathing, but the gastroenterologist later told an inspector that he was “not prepared” to do so.\u003c/p>\n\u003cp>The inability to perform the suffocation-rescue maneuver, the inspection report says, amounted to the center’s “failure to ensure patient safety.”\u003c/p>\n\u003cp>From the time a nurse called 911, it took 24 minutes to get Tam to the nearest hospital, EMS records show. She arrived without a pulse and remained on life support overnight, as her children raced to her bedside to say goodbye.[contextly_sidebar id=\"bLBYWBIiszrFf7LXQxCNRj9SYTbpB4ln\"]\u003c/p>\n\u003cp>The center did not return calls and denied wrongdoing in the court case. Tam’s surgeon declined to discuss the case but filed pleadings in court saying Tam’s “carelessness and negligence” caused her death. It’s unclear what the defense meant by negligence. The case reached a confidential settlement.\u003c/p>\n\u003cp>After Tam’s death, the center told Medicare inspectors that a qualified doctor would stay on-site after all upper-spine cases.\u003c/p>\n\u003cp>Dr. Nancy Epstein, chief of neurosurgical and spine care at New York University Winthrop Hospital, said surgery centers doing delicate work near the spinal cord, windpipe and esophagus in a same-day procedure is “pretty revolting.” But she said the centers are making so much money — “reeling it in hand over fist” that the potential dangers are being ignored.\u003c/p>\n\u003cp>“Medically, it should not be tolerated,” she said, “but it is.”\u003c/p>\n\u003cp>\u003cem>Lindy Washburn of The (Bergen County, N.J.) Record and NorthJersey.com contributed to this report.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The surgery went fine. Her doctors left for the day. Four hours later, Paulina Tam started gasping for air.\u003c/p>\n\u003cp>Internal bleeding was cutting off her windpipe, a well-known complication of the spine surgery she had undergone.\u003c/p>\n\u003cp>But a Medicare inspection report describing the event says that nobody who remained on duty that evening at the Northern California surgery center knew what to do.\u003c/p>\n\u003cp>In desperation, a nurse did something that would not happen in a hospital.\u003c/p>\n\u003cp>She dialed 911.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>By the time an ambulance delivered Tam to the emergency room, the 58-year-old mother of three was lifeless, according to the report.\u003c/p>\n\u003cp>If Tam had been operated on at a hospital, a few simple steps could have saved her life.\u003c/p>\n\u003cp>But like hundreds of thousands of other patients each year, Tam went to one of the nation’s 5,600-plus surgery centers.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Some surgery centers risk patient lives by skimping on training or lifesaving equipment.'\u003c/aside>\n\u003cp>Such centers started nearly 50 years ago as low-cost alternatives for minor surgeries. They now outnumber hospitals as federal regulators have signed off on an ever-widening array of outpatient procedures in an effort to cut federal health care costs.\u003c/p>\n\u003cp>Thousands of times each year, these centers call 911 as patients experience complications ranging from minor to fatal. Yet no one knows how many people die as a result, because no national authority tracks the tragic outcomes. An investigation by Kaiser Health News and the USA TODAY Network has discovered that more than 260 patients have died since 2013 after in-and-out procedures at surgery centers across the country. Dozens — some as young as 2 — have perished after routine operations, such as colonoscopies and tonsillectomies.\u003c/p>\n\u003cp>Reporters examined autopsy records, legal filings and more than 12,000 state and Medicare inspection records, and interviewed dozens of doctors, health policy experts and patients throughout the industry, in the most extensive examination of these records to date.\u003c/p>\n\u003cp>The investigation revealed:\u003c/p>\n\u003cp>Surgery centers have steadily expanded their business by taking on increasingly risky surgeries. At least 14 patients have died after complex spinal surgeries like those that federal regulators at Medicare recently approved for surgery centers. Even as the risks of doing such surgeries off a hospital campus can be great, so is the reward. Doctors who own a share of the center can earn their own fee and a cut of the facility’s fee, a meaningful sum for operations that can cost $100,000 or more.\u003c/p>\n\u003cp>To protect patients, Medicare requires surgery centers to line up a local hospital to take their patients when emergencies arise. In rural areas, centers can be 15 or more miles away. Even when the hospital is close, 20 to 30 minutes can pass between a 911 call and arrival at an ER.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The money overshadows everything.'\u003ccite>Dr. Larry Teuber\u003c/cite>\u003c/aside>\n\u003cp>Some surgery centers are accused of overlooking high-risk health problems and treat patients who experts say should be operated on only in hospitals, if at all. At least 25 people with underlying medical conditions have left surgery centers and died within minutes or days. They include an Ohio woman with out-of-control blood pressure, a 49-year-old West Virginia man awaiting a heart transplant and several children with sleep apnea.\u003c/p>\n\u003cp>Some surgery centers risk patient lives by skimping on training or lifesaving equipment. Others have sent patients home before they were fully recovered. On their drives home, shocked family members in Arkansas, Oklahoma and Georgia discovered their loved ones were not asleep but on the verge of death. Surgery centers have been criticized in cases where staff didn’t have the tools to open a difficult airway or skills to save a patient from bleeding to death.\u003c/p>\n\u003cp>Most operations done in surgery centers go off without a hitch. And surgery carries risk, no matter where it’s done. Some centers have state-of-the-art equipment and highly trained staff that are better prepared to handle emergencies.\u003c/p>\n\u003cp>But Kaiser Health News and the USA TODAY Network found more than a dozen cases where the absence of trained staff or emergency equipment appears to have put patients in peril.\u003c/p>\n\u003cp>\u003cimg class=\"size-medium wp-image-436004 alignleft\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/depression-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\">And in cases similar to Tam’s, upper-spine surgery patients have been sent home too soon, with the risk of suffocation looming.\u003c/p>\n\u003cp>In 2008, a 35-year-old Oregon father of three struggled for air, pounding the car roof in frustration while his wife sped him to a hospital. A Dallas man collapsed in his father’s arms waiting for an ambulance in 2011. Another Oregon man began to suffocate in his living room the night of his upper-spine surgery in 2014. A San Diego man gasped “like a fish,” his wife recalled, as they waited for an ambulance on April 28, 2016.\u003c/p>\n\u003cp>None of them survived.\u003c/p>\n\u003cp>Spinal surgery patient McArthur Roberson, 60, lost more than a quart of blood during the operation and struggled to breathe after surgery, his family claimed in a lawsuit. He died on the way home.\u003c/p>\n\u003cp>If he “had been observed in a hospital overnight,” said Dr. Daniel Silcox, an Atlanta spine surgeon and expert for the family in their lawsuit, “his death would not have occurred.”\u003c/p>\n\u003cp>The surgery center denied wrongdoing in the case, which reached a confidential settlement in 2017.\u003c/p>\n\u003cp>Many in the health care field — from doctors to private insurance companies to Medicare — have dismissed the mounting deaths as medical anomalies beyond the control of physicians.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>USA TODAY Network and KHN reporters contacted 24 doctors and surgery center administrators about patient deaths and none would answer questions about what went wrong, citing patient privacy laws, or referring reporters to attorneys. Responding to lawsuits around the nation, surgery centers have argued that fatal complications were among the known outcomes of such surgeries. Two centers blamed patients for negligence in their own demise.\u003c/p>\n\u003cp>Bill Prentice, chief executive of the Ambulatory Surgery Center Association, declined to speak about individual cases but said he has seen no data proving surgery centers are less safe than hospitals.\u003c/p>\n\u003cp>“There is nothing distinct or different about the surgery center model that makes the provision of health care any more dangerous than anywhere else,” Prentice said. “The human body is a mysterious thing, and a patient that has met every possible protocol can walk in that day and still have something unimaginable happen to them that has nothing to do with the care that’s being provided.”\u003c/p>\n\u003cp>However, Dr. Kenneth Rothfield, board member of the Physician-Patient Alliance for Health & Safety, said many surgery centers and physicians push the envelope on how much can be done in outpatient centers.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“It’s important to realize that surgery centers are not hospitals,” he said. “They have different resources, different equipment.”\u003c/p>\n\u003cp>The explosive growth of surgery centers — which receive $4.1 billion a year from Medicare — has taken place under circumstances some medical experts consider unseemly.\u003c/p>\n\u003cp>Federal law allows surgery center doctors — unlike others — to steer patients to facilities they own, rather than the full-service hospital down the street. In some cases, doing so could increase the risk to a patient, but double a physician’s profits.\u003c/p>\n\u003cp>Prentice said physician ownership of surgery centers is a good thing.\u003c/p>\n\u003cp>“The physicians who practice there are responsible for everything that happens in that surgery center from the moment the patient walks out of their car in the parking lot to the moment they leave,” he said.\u003c/p>\n\u003cp>But several studies have shown that surgery center doctors who are owners perform operations more frequently. And in lawsuits across the country, surgery center doctors have been accused of taking risks with patients.\u003c/p>\n\u003cp>Even some who’ve made their living in the surgery center industry have expressed concerns. Dr. Larry Teuber, a South Dakota neurosurgeon who worked as an executive in the surgery center industry for 22 years, said he has watched surgery center owners take on increasingly complex — and lucrative — orthopedic and spinal surgeries, undercutting a nearby hospital’s profits for their own gain.\u003c/p>\n\u003cp>“When you’re making money doing [complex surgeries] you get on a slippery ethical slope,” Teuber said. “The money overshadows everything.”\u003c/p>\n\u003cp>\u003cstrong>The History\u003c/strong>\u003c/p>\n\u003cp>The first surgery center in the U.S. opened in Phoenix in 1970, a place “squeezed between neighborhood shops and a Baptist church,” where, for $90, a child could receive an incision to relieve pressure on the inner ear, The Arizona Republic reported at the time.\u003c/p>\n\u003cp>The pioneering doctors, John Ford and Wallace Reed, didn’t see why patients needed to be hospitalized for such minor surgeries.\u003c/p>\n\u003cp>Taking the procedures out of hospitals reduced the cost for patients and insurers because surgery centers don’t require the same level of staffing or lifesaving equipment.\u003c/p>\n\u003cp>Medicare helped drive the expansion of surgery centers when it began paying for procedures in 1982.\u003c/p>\n\u003cp>Then in 1993, Congress encouraged doctors to open surgery centers by exempting them from the second Stark Law, which prevents doctors from steering patients to other businesses they own.\u003c/p>\n\u003cfigure id=\"attachment_440038\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-440038\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/iStock-638540542-800x534.jpg\" alt=\"\" width=\"800\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-1920x1281.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-1180x788.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-960x641.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/iStock-638540542-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Surgeons passing scissors to each other \u003ccite>(gpointstudio/IStock)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Doctors-turned-entrepreneurs drove early growth, urging their patients to give the centers a chance. Seeing lucrative elective surgeries moving away, hospitals increasingly bought centers of their own. Last year, insurance giant UnitedHealth Group spent $2.3 billion buying a national surgery center chain.\u003c/p>\n\u003cp>The centers have been popular with patients, who enjoy the convenience and personalized care. Doctors say they like the ease of planning operations without unexpected trauma surgeries upending the schedule. And surgery centers have thrived even as hospitals have battled to contain the spread of infections.\u003c/p>\n\u003cp>Today, there are 5,616 Medicare-certified centers. The expansion has come despite lingering safety concerns. In 2007, Medicare noted that surgery centers “have neither patient safety standards consistent with those in place for hospitals, nor are they required to have the trained staff and equipment needed to provide the breadth of intensity of care. …” Some procedures are “unsafe” to be handled at surgery centers, the report concluded.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Medicare advised the centers to transfer patients to hospitals when emergencies arise. Only a third of surgery centers participate in a voluntary effort to report how often that happens. They sent at least 7,000 patients to the hospital in the year that ended in September 2017, a KHN analysis of surgery center industry data shows. Not all survive the trip.\u003c/p>\n\u003cp>They include James Long, 56, who had no pulse when an ambulance came to the Colorado surgery center where he’d undergone more than five hours of lower-spine surgery in 2014, according to the center’s medical records provided to the family’s attorney.\u003c/p>\n\u003cp>The state reviewed the case and cited no deficiencies. Jen Kenitzer, the Minimally Invasive Spine Institute administrator, said the center has “extensive procedures in place to respond quickly and appropriately” in emergencies.\u003c/p>\n\u003cp>Yet Long’s loved ones remain troubled by the case.\u003c/p>\n\u003cp>“In the 21st century in the USA, a doctor doing a surgery on a patient has to call 911?” said Robin Long, his ex-wife, who did not sue the center. “Give me a break. … It’s just absolutely ignorant.”\u003c/p>\n\u003cp>\u003cstrong>Preparation Under Par\u003c/strong>\u003c/p>\n\u003cp>Patients enter hospitals with heart attacks, gunshot wounds and traumatic injuries. There, doctors and nurses become skilled at saving lives in emergencies.\u003c/p>\n\u003cp>Doctors in surgery centers may excel at the procedures they perform most often. But the centers aren’t always prepared and sometimes struggle in a crisis, according to a review of Medicare records and more than 70 lawsuits.\u003c/p>\n\u003cp>Health inspectors working on behalf of Medicare have discovered 230 lapses in rescue equipment or training regulations at surgery centers since 2015.\u003c/p>\n\u003cp>A center in California had empty oxygen tanks. One operating on children in Arkansas didn’t have a pediatric tracheotomy set to restore breathing; another lacked pediatric defibrillator pads to shock hearts back into rhythm.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In an ongoing lawsuit against her and the center, anesthesiologist Dr. Yoori Yim testified that she came up empty-handed on Dec. 23, 2015, when grappling to find the right-sized airway tube to save a patient who had stopped breathing.\u003c/p>\n\u003cp>Rekhaben Shah, 67, had come to Oak Tree Surgery Center in Edison, N.J., for a simple colonoscopy.\u003c/p>\n\u003cp>Yim tried a variety of methods to help Shah breathe, with limited success. From the moment Shah stopped breathing on the operating table, 33 minutes passed before a paramedic effectively inserted a breathing tube, according to medical and EMS records.\u003c/p>\n\u003cp>Paramedics responding to the center’s 911 call had to use a video GlideScope to see inside the patient’s throat, equipment the surgery center didn’t have, court testimony says.\u003c/p>\n\u003cp>By then it was too late. Shah was removed from life support at a nearby hospital on Christmas Day.\u003c/p>\n\u003cp>Neither Yim nor the center returned calls for comment. In court records, an expert for the surgery center said Shah’s airway was obstructed and it was cleared around the time the paramedics arrived. He said the GlideScope is not required in New Jersey, nor would it likely have made a difference. An expert for Yim, however, said her actions were appropriate and if a GlideScope had been at the center, “we would probably not be discussing this case at all.”\u003c/p>\n\u003cp>When emergency crews arrive, surgery centers are not always prepared to receive them.\u003c/p>\n\u003cp>In Yim’s case, paramedics testified that she refused to move away from Shah and allow them to attempt lifesaving measures.\u003c/p>\n\u003cp>In Florida, paramedics who rushed to a surgery center after its usual operating hours hit a locked door while a patient inside gasped for breath. The 55-year-old remains in a vegetative state.\u003c/p>\n\u003cp>In 2016, paramedics arrived at West Lakes Surgery Center in Iowa as staff tried to revive 12-year-old Reuben Van Veldhuizen after he experienced complications during a tonsillectomy, according to a Medicare inspection report.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>One paramedic told state inspectors she had to ask who was in charge of the resuscitation efforts. No one replied, the inspection report says.\u003c/p>\n\u003cp>The boy made it to the hospital 37 minutes after the surgery center staff called 911. There, he was pronounced dead.\u003c/p>\n\u003cp>The family filed suit, alleging that the center and anesthesiologist erred in giving the boy an anesthetic that carries a warning about cardiac arrest risk in young boys.\u003c/p>\n\u003cp>In court records responding to the lawsuit, the surgery center and anesthesiologist said Reuben’s death was a result of “pre-existing conditions, acts of others, or conditions over which (Defendants) had no control or responsibility.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Yet lawyers who sue the centers and scrutinize their internal records say they often see deadly delays in care.\u003c/p>\n\u003cp>Pedro Maldonado, 59, went to Ambulatory Care Center in New Jersey to have his upper digestive tract scoped. He was discovered unresponsive 10 minutes after the seven-minute procedure, according to his widow’s lawsuit.\u003c/p>\n\u003cp>It took surgery center staff 25 more minutes to start CPR, according to a lawsuit that Philadelphia attorney Glenn Ellis filed on behalf of Maldonado’s widow. Twenty-seven more minutes passed before Maldonado was wheeled into an ER, the widow’s ongoing suit alleges. Maldonado never regained consciousness.\u003c/p>\n\u003cp>Reached by phone, a center administrator declined to comment. In a legal filing, the center denied claims of wrongdoing.\u003c/p>\n\u003cp>“At a hospital, doctors and nurses … know how they are going to respond,” Ellis said. “These guys at the surgery centers are walking on a tightrope with no safety net.”\u003c/p>\n\u003cp>\u003cstrong>Conveyor Belt Of Care\u003c/strong>\u003c/p>\n\u003cp>While the thrum of a hospital continues through the night, some surgery center doctors keep banker’s hours. That means patients whose surgeries end later in the day are sometimes left in the care of one or two nurses for up to 23-hour stays. Some patients have been sent home to grapple with complications on their own.\u003c/p>\n\u003cp>Sondra Wallace went to the Surgery Center of Oklahoma in early 2017 for a sinus procedure.\u003c/p>\n\u003cp>After the procedure, doctors saw her blood-oxygen level sinking. They realized she had had a reaction to the anesthesia and at 2 p.m. gave her a drug to reverse the effects, an ongoing lawsuit filed by her husband says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Then, an hour later, they sent her home with her husband, Larry, the lawsuit says.\u003c/p>\n\u003cp>It was 3 p.m. on the Friday before Presidents Day weekend.\u003c/p>\n\u003cp>“I just think they wanted to start their three-day weekend,” said daughter Casey Podoll.\u003c/p>\n\u003cp>Larry Wallace alleges in the suit that the center gave him no hint that Sondra had a reaction to the anesthesia.\u003c/p>\n\u003cp>So, Wallace thought nothing of her napping in the back seat as he drove for more than two hours through Oklahoma pastures on his way home. When he arrived, he discovered his wife cold in the back seat. She was pronounced dead at Jackson County Memorial Hospital at 6:30 p.m. that day.\u003c/p>\n\u003cp>“They didn’t give any indication … that there were any red flags whatsoever,” Podoll said.\u003c/p>\n\u003cp>Craig Buchan, attorney for the Surgery Center of Oklahoma, said Wallace met discharge criteria and her cause of death has not been determined. He said the center did not close any earlier “than often occurs after the last patient is discharged.”\u003c/p>\n\u003cp>Cecilia Aldridge said she also felt as if the staff at a surgery center was rushing her out the door, after her 2-year-old daughter’s tonsil surgery in Arkansas in 2015.\u003c/p>\n\u003cp>A lawsuit filed by the parents said the surgery center “discharged Abbygail too early because a snow storm was moving into the area.”\u003c/p>\n\u003cp>Abbygail turned blue in the car on the way home. Her mother said she raced into an emergency room, shouting for help, her toddler in her arms.\u003c/p>\n\u003cp>“She never woke up,” Aldridge said tearfully in an interview.\u003c/p>\n\u003cp>Abbygail’s parents now question whether the surgery center ever should have been willing to treat their daughter.\u003c/p>\n\u003cp>\u003cstrong>Risky Patients\u003c/strong>\u003c/p>\n\u003cp>Because surgery centers have less safety equipment and staffing than hospitals, industry leaders stress the importance of selecting patients healthy enough to fare well. Their predictions, though, are not always correct.\u003c/p>\n\u003cp>Abbygail, who loved her hand-me-down blanket and the film “Frozen,” had sleep apnea, an irregular heartbeat and was very heavy for her age, according to the lawsuit.\u003c/p>\n\u003cp>Sleep apnea increases the risk of serious complications in surgery and the night after, medical research shows. Given her condition, Abbygail “should have been admitted [to a hospital] and monitored post-procedure,” said Dr. Charles Cote, a retired Harvard pediatric anesthesiology professor who was not involved in the family’s lawsuit.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The lawsuit says Abbygail’s risk factors “were documented and known by the Defendants,” including the doctor. It said the toddler should have been operated on “in an inpatient setting under hospital care and monitored overnight.”\u003c/p>\n\u003cp>Dr. Michael Marsh performed Abbygail’s tonsillectomy at Executive Park Surgery Center in Fort Smith, Ark.\u003c/p>\n\u003cp>The surgery center’s lawyer declined to comment. The doctor’s lawyer did not return email and voice messages. In court documents responding to the lawsuit, Marsh and the center denied wrongdoing.\u003c/p>\n\u003cp>In the court filing, Marsh said the toddler’s injuries were “the natural progression” of her illness. Executive Park Surgery Center said in a court filing that “no action on their part … was a proximate cause of any damages or injury.” The case was settled.\u003c/p>\n\u003cp>In at least 25 cases, surgery centers opened their doors to ailing and fragile patients who died after simple procedures, such as tonsillectomies, retinal repairs or colonoscopies, KHN and USA TODAY Network found.\u003c/p>\n\u003cp>Medicare asks surgery centers to assess each patient’s risk, but inspectors flagged 122 surgery centers in 2015 and 2016 alone for lapses in risk assessments. Some centers failed to gauge risk at all. Others overlooked their own policies.\u003c/p>\n\u003cp>Doctors can use an anesthesia risk assessment to screen out fragile patients — healthy patients get a score of 1, and a score of 5 means a person is nearly dead.\u003c/p>\n\u003cp>A few states, including Pennsylvania and Rhode Island, bar certain surgery centers from operating on patients with an anesthesia risk score of 4. But most states don’t go that far. They leave such decisions up to doctors.\u003c/p>\n\u003cp>And some of those decisions have been cited in tragic outcomes. Sabino Sifuentes, 74, had survived triple-bypass surgery. But on March 23, 2015, nine minutes after the start of anesthesia for an eye procedure, he became unresponsive, never to be revived, according to a Medicare inspection report. A nurse anesthetist who reviewed the case at Eye-Q Vision Care’s surgery center in Fresno, Calif., told state health inspectors that Sifuentes should have been given a risk score of 4 and his care was “completely mismanaged,” the inspection report says.\u003c/p>\n\u003cp>In response to the family’s lawsuit, the surgery center said Sifuentes’ injury was caused by his own negligence and others’.\u003c/p>\n\u003cp>Five other patients with the same risk score died after routine procedures at surgery centers across the U.S.\u003c/p>\n\u003cp>\u003cstrong>A Widening Niche\u003c/strong>\u003c/p>\n\u003cp>Such tragedies rarely find their way into the discussion when Medicare decides whether to approve new procedures at surgery centers.\u003c/p>\n\u003cp>Take spinal surgery.\u003c/p>\n\u003cp>Until 2015, Medicare wouldn’t pay for it at surgery centers. Then, the industry’s trade association urged the agency to make the change, and encouraged a letter-writing campaign from surgery centers across the nation.\u003c/p>\n\u003cp>Letter writers included Dr. Alan Villavicencio, a Colorado surgeon who said he’d been doing such surgeries for 12 years and found that his patients “appreciate the convenience and cost savings.” He did not mention that James Long, 56, had died three weeks earlier at a Lafayette, Colo., surgery center where he is an owner, a review of Colorado health department and medical board records shows.\u003c/p>\n\u003cp>United Surgical Partners International, a surgery center chain, also weighed in urging even more procedures to be approved, not mentioning a patient death hours after a spine surgery at one of its affiliate centers several months before, according to court records and securities filings. The chain said in a statement that it stands behind its comments in support of the proposal.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Such letters carry weight with Medicare, which approves procedures to be done in surgery centers based on the invasiveness and complexity of the surgery and on input from stakeholders.\u003c/p>\n\u003cp>Robert Beatty-Walters, a Portland, Ore., attorney who has represented the families of three people who died after surgery center spine procedures, said Medicare’s decision-making process is not even-handed.\u003c/p>\n\u003cp>“The stakeholders — they call them — during these regulatory proceedings are the profit-makers, not the people who are being provided the service,” he said. “The spine centers just want to have more people come. They make more money. I hate to be that cynical about it, but that’s just what I’ve seen.”\u003c/p>\n\u003cp>Medicare approved 10 spine-surgery codes to be billed at surgery centers starting in 2015 and added more spinal procedures for 2017. A Medicare spokesman denied a request for a telephone interview. In an email, a spokeswoman said Medicare opened the spine proposal to the public and received no comments suggesting the procedures would pose a threat to Medicare patients. She said the final decision about where a patient will have surgery is up to a doctor and patient.\u003c/p>\n\u003cp>By 2017, at least 14 patients had died soon after spine operations at surgery centers, according to the KHN/USA TODAY Network investigation.\u003c/p>\n\u003cp>The 14 spine-surgery deaths have gleaned little recognition in the industry or beyond. Only one made headlines in local newspapers. The rest are documented in places like the Macon, Ga., courthouse or in obscure regulatory reports. And there may be far more because some states, including New York, Illinois and Florida, disclose no details about surgery center deaths.\u003c/p>\n\u003cp>Paulina Tam’s death at Fremont Surgery Center was a tragic example. At 58, the mother of three had finished careers as a nurse and an educator. Next, she planned to travel the world with her husband of 32 years.\u003c/p>\n\u003cp>“She was the driving force of the family, the spirit I guess,” said her son, Eric Tam, a doctor in New York City, said. “We didn’t expect the worst to happen.”\u003c/p>\n\u003cp>The care she received at the center is documented in court records, EMS reports and a Medicare inspection report that concluded that the center “failed to provide a safe environment for surgery.”\u003c/p>\n\u003cp>Tam’s doctor scheduled her for a procedure to replace two discs in her upper spine on April 7, 2014. Pain from a car crash had bothered her for years. Any such surgery — entering the front of the neck to address pain in the spine — comes with a risk of suffocation, according to the Medicare inspection report.\u003c/p>\n\u003cp>Yet, with her surgeon and anesthesiologist already gone, the only doctor on-site was a digestive health specialist, the inspection report shows. About four hours after her procedure, Tam told a nurse that her surgical collar felt too tight. Then, that she couldn’t breathe.\u003c/p>\n\u003cp>The nurse called a “code blue” just after 6:30 p.m., records say.\u003c/p>\n\u003cp>Medical experts say the first step in helping such patients is removing the surgical staples so the pooled blood can disperse, allowing the patient to breathe.\u003c/p>\n\u003cp>In Tam’s case, staff repeatedly tried and failed to insert a breathing tube through her mouth and into her airway, the inspection report shows. A last-ditch remedy would have been to punch a hole through the front of her throat to restore breathing, but the gastroenterologist later told an inspector that he was “not prepared” to do so.\u003c/p>\n\u003cp>The inability to perform the suffocation-rescue maneuver, the inspection report says, amounted to the center’s “failure to ensure patient safety.”\u003c/p>\n\u003cp>From the time a nurse called 911, it took 24 minutes to get Tam to the nearest hospital, EMS records show. She arrived without a pulse and remained on life support overnight, as her children raced to her bedside to say goodbye.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The center did not return calls and denied wrongdoing in the court case. Tam’s surgeon declined to discuss the case but filed pleadings in court saying Tam’s “carelessness and negligence” caused her death. It’s unclear what the defense meant by negligence. The case reached a confidential settlement.\u003c/p>\n\u003cp>After Tam’s death, the center told Medicare inspectors that a qualified doctor would stay on-site after all upper-spine cases.\u003c/p>\n\u003cp>Dr. Nancy Epstein, chief of neurosurgical and spine care at New York University Winthrop Hospital, said surgery centers doing delicate work near the spinal cord, windpipe and esophagus in a same-day procedure is “pretty revolting.” But she said the centers are making so much money — “reeling it in hand over fist” that the potential dangers are being ignored.\u003c/p>\n\u003cp>“Medically, it should not be tolerated,” she said, “but it is.”\u003c/p>\n\u003cp>\u003cem>Lindy Washburn of The (Bergen County, N.J.) Record and NorthJersey.com contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "FDA Approves First Direct-to-Consumer Test for Breast Cancer Risk",
"title": "FDA Approves First Direct-to-Consumer Test for Breast Cancer Risk",
"headTitle": "Future of You | KQED Future of You | KQED Science",
"content": "\u003cp>Federal regulators approved the first direct-to-consumer test for the BRCA genes, which increase the risk of breast and ovarian cancer, the agency announced on Tuesday.\u003c/p>\n\u003cp>The test for the BRCA1 and BRCA2 genes, from \u003ca href=\"https://www.statnews.com/2017/04/07/genetic-analysis-need-to-know/\" target=\"_blank\" rel=\"noopener\">23andMe\u003c/a>, uses a saliva sample. But it assesses only three of the more than 1,000 known BRCA1/2 mutations, raising concerns that women who are told they do not have any of those variants will be lulled into believing that, as a result, they do not have an elevated risk for breast and ovarian cancer.\u003c/p>\n\u003cp>The three specific BRCA1/BRCA2 breast cancer \u003ca href=\"https://www.kqed.org/futureofyou/439059/why-even-siblings-can-get-different-ancestry-results-from-dna-tests\" target=\"_blank\" rel=\"noopener\">gene mutations \u003c/a>are most common in people with Ashkenazi (Eastern European) Jewish ancestry, accounting for more than 90 percent of their risk of heritable breast and ovarian cancer. But even in this population only 2 percent of women carry any of these three so-called “founder” mutations, the FDA said. Women with one of the mutations have a 45 percent to 85 percent chance of developing breast cancer by age 70, 23andMe said.\u003c/p>\n\u003cp>[contextly_sidebar id=\"n8fyxUwdBRcgBMG96UbMv2Lu8p4ZNItq\"]But these three variants are not the most common BRCA1/BRCA2 mutations in the general population: No more than 0.1 percent of women with non-Ashkenazi ancestry carry the mutations. “A negative result does not rule out the possibility that an individual carries other BRCA mutations that increase cancer risk,” the FDA warned.\u003c/p>\n\u003cp>\u003cstrong>Test Limitations\u003c/strong>\u003cbr>\nThe 23andMe test “is a step forward in the availability of DTC genetic tests,” Donald St. Pierre, acting director of the FDA’s Office of In Vitro Diagnostics and Radiological Health, said in a statement. “But it has a lot of caveats.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The agency therefore warned that individuals and their physicians should not use the test results to make decisions about treatments, including prophylactic removal of the breasts or ovaries. That should be based on more extensive testing. Myriad Genetics, which developed the first BRCA1/2 tests, assesses DNA for thousands of variants; it has long \u003ca href=\"http://investor.myriad.com/releasedetail.cfm?releaseid=1021443\" target=\"_blank\" rel=\"noopener\">warned\u003c/a> that other tests, which came on the market after the Supreme Court threw out Myriad’s key BRCA patents, could mislead women.\u003c/p>\n\u003cp>In addition, most cases of breast cancer are not hereditary, from BRCA or other mutations, but “sporadic,” meaning they arise at random or from smoking, obesity, exposure to toxic chemicals, hormone use, and other environmental factors.[contextly_sidebar id=\"ixqQWxrYKmKKTNT32BcHv1EguBJm96pF\"]\u003c/p>\n\u003cp>“At a minimum, 23andMe should be clear with people about what their test is and isn’t and present the information in a fair and balanced way that the average person can understand,” said Myriad spokesman Ron Rogers, who added that some customers might be uncomfortable about 23andMe’s \u003ca href=\"https://gizmodo.com/what-dna-testing-companies-terrifying-privacy-policies-1819158337\" target=\"_blank\" rel=\"noopener\">selling\u003c/a> of genetic information to third parties.\u003c/p>\n\u003cp>For women with Ashkenazi ancestry, the test “is not too bad as a screen,” said Robert Cook-Deegan of Arizona State University, a longtime scholar in the field of genomics ethics and law. “But for other groups with different founder mutations, and there are many, it won’t help much. There’s a big need for users to understand that nuance, which is not widely understood.”\u003c/p>\n\u003cp>\u003cstrong>Direct-to-Consumer Tests\u003c/strong>\u003cbr>\nThe FDA’s decision was based on data from 23andMe showing that its test can accurately identify the three genetic variants in saliva samples. The privately held company also submitted studies showing that consumers understood the report it will send to customers on what the results might mean, how to interpret them, and where to find additional information.\u003c/p>\n\u003cp>“Being the first and only direct-to-consumer genetics company to receive FDA authorization to test for cancer risk without a prescription is a major milestone for 23andMe and for the consumer,” Anne Wojcicki, 23andMe CEO and co-founder, said in a statement. “We believe it’s important for consumers to have direct and affordable access to this potentially life-saving information. … This authorization is incredibly valuable for those who might not be aware of their Ashkenazi Jewish descent.”\u003c/p>\n\u003cp>She, too, emphasized that “our test does not account for all genetic variants that can cause a higher risk of cancer, and people should continue with their recommended cancer screenings.” Myriad, for instance, has identified some 20,000 BRCA1/2 variants.\u003c/p>\n\u003cp>The decision follows one last year in which the FDA gave 23andMe the go-ahead to sell DNA tests assessing customers’ risk of 10 diseases, including Parkinson’s and late-onset Alzheimer’s. Those were the first FDA-approved direct-to-consumer tests for genetic risk of any disease or condition, which the agency said could help people make lifestyle decisions. At the time, the FDA also warned that genetic risk for complex diseases is not a sure thing: People whose 23andMe test does not find genetic variants that increase the risk of a disease can still develop it, and people whose DNA test shows no disease-causing variants might not.\u003c/p>\n\u003cp>The BRCA test will be part of 23andme’s $199 Health + Ancestry test. Existing customers can opt to receive BRCA information for no additional cost, and as with the other disease-risk tests they as well as new customers must specifically choose to receive the information.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“My libertarian streak says this, properly understood, is a good thing that increases access,” said Cook-Deegan, “although I do worry about proliferation of commercial purveyors as the sources of information and keeping the data.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Federal regulators approved the first direct-to-consumer test for the BRCA genes, which increase the risk of breast and ovarian cancer, the agency announced on Tuesday.\u003c/p>\n\u003cp>The test for the BRCA1 and BRCA2 genes, from \u003ca href=\"https://www.statnews.com/2017/04/07/genetic-analysis-need-to-know/\" target=\"_blank\" rel=\"noopener\">23andMe\u003c/a>, uses a saliva sample. But it assesses only three of the more than 1,000 known BRCA1/2 mutations, raising concerns that women who are told they do not have any of those variants will be lulled into believing that, as a result, they do not have an elevated risk for breast and ovarian cancer.\u003c/p>\n\u003cp>The three specific BRCA1/BRCA2 breast cancer \u003ca href=\"https://www.kqed.org/futureofyou/439059/why-even-siblings-can-get-different-ancestry-results-from-dna-tests\" target=\"_blank\" rel=\"noopener\">gene mutations \u003c/a>are most common in people with Ashkenazi (Eastern European) Jewish ancestry, accounting for more than 90 percent of their risk of heritable breast and ovarian cancer. But even in this population only 2 percent of women carry any of these three so-called “founder” mutations, the FDA said. Women with one of the mutations have a 45 percent to 85 percent chance of developing breast cancer by age 70, 23andMe said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>But these three variants are not the most common BRCA1/BRCA2 mutations in the general population: No more than 0.1 percent of women with non-Ashkenazi ancestry carry the mutations. “A negative result does not rule out the possibility that an individual carries other BRCA mutations that increase cancer risk,” the FDA warned.\u003c/p>\n\u003cp>\u003cstrong>Test Limitations\u003c/strong>\u003cbr>\nThe 23andMe test “is a step forward in the availability of DTC genetic tests,” Donald St. Pierre, acting director of the FDA’s Office of In Vitro Diagnostics and Radiological Health, said in a statement. “But it has a lot of caveats.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The agency therefore warned that individuals and their physicians should not use the test results to make decisions about treatments, including prophylactic removal of the breasts or ovaries. That should be based on more extensive testing. Myriad Genetics, which developed the first BRCA1/2 tests, assesses DNA for thousands of variants; it has long \u003ca href=\"http://investor.myriad.com/releasedetail.cfm?releaseid=1021443\" target=\"_blank\" rel=\"noopener\">warned\u003c/a> that other tests, which came on the market after the Supreme Court threw out Myriad’s key BRCA patents, could mislead women.\u003c/p>\n\u003cp>In addition, most cases of breast cancer are not hereditary, from BRCA or other mutations, but “sporadic,” meaning they arise at random or from smoking, obesity, exposure to toxic chemicals, hormone use, and other environmental factors.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“At a minimum, 23andMe should be clear with people about what their test is and isn’t and present the information in a fair and balanced way that the average person can understand,” said Myriad spokesman Ron Rogers, who added that some customers might be uncomfortable about 23andMe’s \u003ca href=\"https://gizmodo.com/what-dna-testing-companies-terrifying-privacy-policies-1819158337\" target=\"_blank\" rel=\"noopener\">selling\u003c/a> of genetic information to third parties.\u003c/p>\n\u003cp>For women with Ashkenazi ancestry, the test “is not too bad as a screen,” said Robert Cook-Deegan of Arizona State University, a longtime scholar in the field of genomics ethics and law. “But for other groups with different founder mutations, and there are many, it won’t help much. There’s a big need for users to understand that nuance, which is not widely understood.”\u003c/p>\n\u003cp>\u003cstrong>Direct-to-Consumer Tests\u003c/strong>\u003cbr>\nThe FDA’s decision was based on data from 23andMe showing that its test can accurately identify the three genetic variants in saliva samples. The privately held company also submitted studies showing that consumers understood the report it will send to customers on what the results might mean, how to interpret them, and where to find additional information.\u003c/p>\n\u003cp>“Being the first and only direct-to-consumer genetics company to receive FDA authorization to test for cancer risk without a prescription is a major milestone for 23andMe and for the consumer,” Anne Wojcicki, 23andMe CEO and co-founder, said in a statement. “We believe it’s important for consumers to have direct and affordable access to this potentially life-saving information. … This authorization is incredibly valuable for those who might not be aware of their Ashkenazi Jewish descent.”\u003c/p>\n\u003cp>She, too, emphasized that “our test does not account for all genetic variants that can cause a higher risk of cancer, and people should continue with their recommended cancer screenings.” Myriad, for instance, has identified some 20,000 BRCA1/2 variants.\u003c/p>\n\u003cp>The decision follows one last year in which the FDA gave 23andMe the go-ahead to sell DNA tests assessing customers’ risk of 10 diseases, including Parkinson’s and late-onset Alzheimer’s. Those were the first FDA-approved direct-to-consumer tests for genetic risk of any disease or condition, which the agency said could help people make lifestyle decisions. At the time, the FDA also warned that genetic risk for complex diseases is not a sure thing: People whose 23andMe test does not find genetic variants that increase the risk of a disease can still develop it, and people whose DNA test shows no disease-causing variants might not.\u003c/p>\n\u003cp>The BRCA test will be part of 23andme’s $199 Health + Ancestry test. Existing customers can opt to receive BRCA information for no additional cost, and as with the other disease-risk tests they as well as new customers must specifically choose to receive the information.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“My libertarian streak says this, properly understood, is a good thing that increases access,” said Cook-Deegan, “although I do worry about proliferation of commercial purveyors as the sources of information and keeping the data.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Feds Hobble Potential Cannabis Treatments for Opioid Addiction",
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"content": "\u003cp>When she started collecting brains, neuroscientist Yasmin Hurd’s peers wondered what she could possibly be thinking.\u003c/p>\n\u003cp>Studying animals made way more sense as a way to trace how chronic drug use changes the brain, they thought — after all, how was Hurd going to parse the long-term effects from the trauma of the overdoses that killed the brain donors?\u003c/p>\n\u003cp>She waved her colleagues off. She wanted to know what was happening in human brains, not in mice.[contextly_sidebar id=\"xjgcW8qRPdqM7MN9tkvvBeggkwrVyhgv\"]\u003c/p>\n\u003cp>So she began filling up freezers with slices of brain tissue from hundreds of overdose victims, most of them killed by too much cocaine.\u003c/p>\n\u003cp>“We had a lot of freezers, sadly,” said Hurd, who now runs the Addiction Institute at the Mount Sinai School of Medicine. And then, early in the 2000s, she noticed a tidal shift: Suddenly, the overdoses were dominated by heroin.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She saw the opioid crisis coming. Ever since, she’s been trying to figure out how to intervene — could she modify or reverse the way addiction changed the brains being studied in her lab?\u003c/p>\n\u003cp>Hurd has honed in on cannabidiol, one of the two main compounds plucked from the marijuana plant. She thinks it might hold the potential to curb cravings for heroin and other opioids.\u003c/p>\n\u003cp>She’s running against the wind. Cannabidiol is classified as a Schedule I drug, meaning the U.S. government thinks it carries severe safety concerns, no medicinal benefits, and a high risk of abuse. Even as a growing number of states legalize marijuana, the hard-line federal stance has made it difficult to do clinical research involving cannabis in this country.\u003c/p>\n\u003caside class=\"pullquote alignright\">'You have to treat every epidemic the same, whether it’s a drug epidemic or a viral epidemic.'\u003ccite>Dr. Yasmin Hurd\u003c/cite>\u003c/aside>\n\u003cp>But Hurd is throwing all of her weight into studying whether it can combat addiction. And she’s trying to rally other scientists to do the same, by creating a consortium to conduct cannabidiol clinical trials across the globe.\u003c/p>\n\u003cp>“If this is something that could be potentially beneficial, and there’s an indication that it could be beneficial,” Hurd said in an interview, “why not put all hands on deck?”\u003c/p>\n\u003cp>Hurd has the reputation and academic standing to pull this off — last fall, she was named to the prestigious National Academy of Medicine, along with dozens of other top-tier researchers.\u003c/p>\n\u003cp>More than that, she has determination: On the front of her computer screen, she’s stuck up a yellow Post-it note that says, “GAIN CONTROL.” Only she’s crossed out “GAIN,” and replaced it with “TAKE.”\u003c/p>\n\u003cp>\u003cstrong>Unraveling The Biology of Addiction\u003cbr>\n\u003c/strong>Hurd has always had what she calls a “pure fascination” with the brain. Her own bounces quickly from one thought to the next, sometimes leaving threads unfinished for the sake of starting a new one. One idea may spin off into a dozen new ones. During a recent interview, she jumped from why she finds outliers in science so intriguing to why she loves murder mysteries (Alfred Hitchcock is a personal favorite).\u003c/p>\n\u003cp>That mental multitasking is mirrored in her lab, where her team is working on a slew of projects, from how chronic drug use restructures the brain to how the brain’s circuits play a role in psychiatric disease.\u003c/p>\n\u003cp>“My research, unfortunately, reflects me,” she said.\u003c/p>\n\u003cp>Her mind is constantly hunting for new ideas in unlikely, often difficult places — like on the list of Schedule I drugs.\u003c/p>\n\u003cp>Past studies have shown that cannabidiol works on a number of brain circuits involved in addiction and drug-seeking behavior. That’s made it an exciting pharmacological target — but the data, by and large, have just been preliminary and unpersuasive. Hurd started looking for more concrete evidence on cannabidiol.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The hard-line federal stance has made it difficult to do clinical research involving cannabis in this country.'\u003c/aside>\n\u003cp>The compound is one of the two main cannabinoids found in the marijuana plant, the other being tetrahydrocannabinol, or THC. But unlike THC, cannabidiol doesn’t get people high. Scientists are studying whether the compound can treat conditions such as epilepsy and anxiety. Hurd is testing whether cannabidiol can cut down on cravings in patients who are addicted to opioids — and in turn, can prevent relapse.\u003c/p>\n\u003cp>In her research on animals, the compound has decreased cravings and anxiety without producing any psychoactive effects. But she’s not sure why, exactly, it’s working. So at the same time, she’s orchestrating studies to delve into the biology that underlies addiction.\u003c/p>\n\u003cp>Some quick background: The neurons in the brain talk to each other through neurotransmitters such as dopamine, serotonin, and endocannabinoids. Those chemical messengers ferry information between brain cells through a synapse, which is the intersection between two neurons. Drugs like heroin are like a car crash — they damage those synapses to the point that other cars can’t get through.[contextly_sidebar id=\"lXwRcOY5jUafks0cGN2BzjpnPSmw1csG\"]\u003c/p>\n\u003cp>Hurd’s lab is studying the wreckage through research like the experiment that one of her postdoctoral researchers, Noel Warren, is working on. Warren hits rat neurons with a compound that mimics chronic heroin use to see how synaptic plasticity — the way the brain changes the connections among neurons, forming new ones while pruning others — is different in the brain after drug use.\u003c/p>\n\u003cp>Based on her findings, Hurd has launched trials to test cannabidiol in humans — but that’s no easy task.\u003c/p>\n\u003cp>\u003cstrong>‘The Hurdles Are Enormous’\u003cbr>\n\u003c/strong>Studying cannabidiol is daunting, and not just because the brain is so complex. To use cannabidiol or any part of the cannabis plant for research, a scientist has to get a special license from the Drug Enforcement Administration, which can take years. Then, scientists have to get approval from the Food and Drug Administration to administer it to patients.\u003c/p>\n\u003cp>“The hurdles are enormous,” said Margaret Haney, a neurobiologist at Columbia University who studies cannabis use disorder and the therapeutic potential of cannabinoids in humans. Haney has to keep the cannabis used in her trials in a gun safe that’s stashed inside a freezer that’s sitting in a special room in her lab that can only be accessed with her fingerprint. That’s routine for cannabis research.\u003c/p>\n\u003cp>\u003cimg class=\" wp-image-128930 alignleft\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/medmar-800x533.jpg\" alt=\"\" width=\"423\" height=\"282\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar-960x640.jpg 960w\" sizes=\"(max-width: 423px) 100vw, 423px\">And patients who are enrolled in clinical trials involving cannabis have to come to the lab of the researcher who holds a DEA license to get the drug, which isn’t always doable for individuals with serious medical conditions.\u003c/p>\n\u003cp>“Our hands are tied even though cannabidiol is not addictive,” Hurd said. But because it derives from the cannabis plant, the government classifies it as a Schedule I drug — like heroin, LSD, ecstasy, and peyote — which are considered to be harmful and have no medicinal value.\u003c/p>\n\u003cp>That means there are relatively few scientists doing research involving cannabis, and even fewer studying its potential to treat addiction or testing cannabidiol in humans. Hurd isn’t in a crowded field.\u003c/p>\n\u003cp>“There’s really not that many people that do that,” said Dr. Sachin Patel, of Vanderbilt University, who has done research with cannabis to understand how marijuana exposure early in life raises the risk of psychiatric disorders.\u003c/p>\n\u003cp>And then, there’s the issue of supply.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Our hands are tied even though cannabidiol is not addictive.'\u003ccite>Dr. Yasmin Hurd\u003c/cite>\u003c/aside>\n\u003cp>For decades, the only sanctioned source of marijuana available for U.S. research was the University of Mississippi, which held an exclusive contract with the federal government.\u003c/p>\n\u003cp>“If you’re trying to do a clinical trial and you need cannabidiol, it’s actually quite difficult to get the types of cannabis needed to do the research,” said Patel.\u003c/p>\n\u003cp>Hurd said the restricted supply has made it all but impossible for her to study the specific formulations of cannabidiol she suspects would be the most therapeutic.\u003c/p>\n\u003cp>She is currently running Phase 2 clinical trials in New York to test cannabidiol’s ability to reduce cravings in people addicted to heroin. And she’s initiating similar studies to test cannabidiol soon in Canada and Jamaica.\u003c/p>\n\u003caside class=\"pullquote alignright\">'[T]he process has felt painstakingly slow when people are dying so quickly.'\u003c/aside>\n\u003cp>But for Hurd, the process has felt painstakingly slow when people are dying so quickly. An estimated 63,600 people died of drug overdoses in 2016. Two-thirds of those deaths were caused by opioids.\u003c/p>\n\u003cp>Hurd is frustrated by how both the government is grappling with the crisis. It’s paled in comparison to the response to the Zika virus and other public health concerns in recent years, she said.\u003c/p>\n\u003cp>“People swarmed to do something. That did not happen with the opioid epidemic,” Hurd said.\u003c/p>\n\u003cp>\u003cimg class=\"alignnone wp-image-435640 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/09/iStock-594036552-800x668.jpg\" alt=\"\" width=\"384\" height=\"321\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-800x668.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-160x134.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-768x641.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-1020x852.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-1180x985.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-960x801.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-240x200.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-375x313.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-520x434.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552.jpg 1895w\" sizes=\"(max-width: 384px) 100vw, 384px\">\u003c/p>\n\u003cp>Why not? Hurd blames it, in large part, on discrimination against people who are addicted to drugs. But if there were more federal funding for research, Hurd said, scientists could accelerate the search for solutions.\u003c/p>\n\u003cp>“You have to treat every epidemic the same,” she said, “whether it’s a drug epidemic or a viral epidemic.”\u003c/p>\n\u003cp>She’s quick to note that she’s not arguing that cannabidiol is a cure-all for the crisis. Hurd just wants to have enough researchers working on the problem that they can quickly say whether something works — or whether it doesn’t — and then move on.\u003c/p>\n\u003cp>Haney, the Columbia neurobiologist, echoed that frustration. The DEA said it has not rescheduled cannabis because there aren’t enough studies to show it has medical potential. But until it’s rescheduled, Haney said, those kind of large, randomized studies won’t really be feasible.\u003c/p>\n\u003cp>“We’re in a vicious cycle,” she said.\u003c/p>\n\u003cp>And dispensaries and cannabis companies in the 29 states that have already legalized medical marijuana don’t have any incentive to fund or conduct clinical trials on the medical benefits, experts say, because they’re already able to sell their products to patients without government approval.\u003c/p>\n\u003cp>“The money-making is all happening outside of any data,” Haney said.\u003c/p>\n\u003cp>So Hurd is trying to spur her fellow scientists to do as much research as possible on the potential of cannabidiol to treat opioid addiction, in a bid to build a cannabinoid consortium. She’s connected with clinicians, pharmacologists, and neuroscientists to talk about how to spur new research. And she’s working to rope in companies interested in cannabidiol, too. Without National Institutes of Health funding for such a project, she’s hopeful they’ll help fund the consortium.\u003c/p>\n\u003cp>Her goal: build an infrastructure that’s far broader than her own.\u003c/p>\n\u003cp>“I don’t need to be the only person in the room studying cannabidiol for opioid addiction,” she said. “It can’t be done with just one little Yasmin Hurd lab.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This article is reproduced with permission from \u003ca href=\"https://www.statnews.com/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>. It was first published on Feb. 28, 2018. Find the original story \u003ca href=\"https://www.statnews.com/2018/02/28/marijuana-cannabidiol-opioids-addiction/\" target=\"_blank\" rel=\"noopener\">here\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When she started collecting brains, neuroscientist Yasmin Hurd’s peers wondered what she could possibly be thinking.\u003c/p>\n\u003cp>Studying animals made way more sense as a way to trace how chronic drug use changes the brain, they thought — after all, how was Hurd going to parse the long-term effects from the trauma of the overdoses that killed the brain donors?\u003c/p>\n\u003cp>She waved her colleagues off. She wanted to know what was happening in human brains, not in mice.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>So she began filling up freezers with slices of brain tissue from hundreds of overdose victims, most of them killed by too much cocaine.\u003c/p>\n\u003cp>“We had a lot of freezers, sadly,” said Hurd, who now runs the Addiction Institute at the Mount Sinai School of Medicine. And then, early in the 2000s, she noticed a tidal shift: Suddenly, the overdoses were dominated by heroin.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She saw the opioid crisis coming. Ever since, she’s been trying to figure out how to intervene — could she modify or reverse the way addiction changed the brains being studied in her lab?\u003c/p>\n\u003cp>Hurd has honed in on cannabidiol, one of the two main compounds plucked from the marijuana plant. She thinks it might hold the potential to curb cravings for heroin and other opioids.\u003c/p>\n\u003cp>She’s running against the wind. Cannabidiol is classified as a Schedule I drug, meaning the U.S. government thinks it carries severe safety concerns, no medicinal benefits, and a high risk of abuse. Even as a growing number of states legalize marijuana, the hard-line federal stance has made it difficult to do clinical research involving cannabis in this country.\u003c/p>\n\u003caside class=\"pullquote alignright\">'You have to treat every epidemic the same, whether it’s a drug epidemic or a viral epidemic.'\u003ccite>Dr. Yasmin Hurd\u003c/cite>\u003c/aside>\n\u003cp>But Hurd is throwing all of her weight into studying whether it can combat addiction. And she’s trying to rally other scientists to do the same, by creating a consortium to conduct cannabidiol clinical trials across the globe.\u003c/p>\n\u003cp>“If this is something that could be potentially beneficial, and there’s an indication that it could be beneficial,” Hurd said in an interview, “why not put all hands on deck?”\u003c/p>\n\u003cp>Hurd has the reputation and academic standing to pull this off — last fall, she was named to the prestigious National Academy of Medicine, along with dozens of other top-tier researchers.\u003c/p>\n\u003cp>More than that, she has determination: On the front of her computer screen, she’s stuck up a yellow Post-it note that says, “GAIN CONTROL.” Only she’s crossed out “GAIN,” and replaced it with “TAKE.”\u003c/p>\n\u003cp>\u003cstrong>Unraveling The Biology of Addiction\u003cbr>\n\u003c/strong>Hurd has always had what she calls a “pure fascination” with the brain. Her own bounces quickly from one thought to the next, sometimes leaving threads unfinished for the sake of starting a new one. One idea may spin off into a dozen new ones. During a recent interview, she jumped from why she finds outliers in science so intriguing to why she loves murder mysteries (Alfred Hitchcock is a personal favorite).\u003c/p>\n\u003cp>That mental multitasking is mirrored in her lab, where her team is working on a slew of projects, from how chronic drug use restructures the brain to how the brain’s circuits play a role in psychiatric disease.\u003c/p>\n\u003cp>“My research, unfortunately, reflects me,” she said.\u003c/p>\n\u003cp>Her mind is constantly hunting for new ideas in unlikely, often difficult places — like on the list of Schedule I drugs.\u003c/p>\n\u003cp>Past studies have shown that cannabidiol works on a number of brain circuits involved in addiction and drug-seeking behavior. That’s made it an exciting pharmacological target — but the data, by and large, have just been preliminary and unpersuasive. Hurd started looking for more concrete evidence on cannabidiol.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The hard-line federal stance has made it difficult to do clinical research involving cannabis in this country.'\u003c/aside>\n\u003cp>The compound is one of the two main cannabinoids found in the marijuana plant, the other being tetrahydrocannabinol, or THC. But unlike THC, cannabidiol doesn’t get people high. Scientists are studying whether the compound can treat conditions such as epilepsy and anxiety. Hurd is testing whether cannabidiol can cut down on cravings in patients who are addicted to opioids — and in turn, can prevent relapse.\u003c/p>\n\u003cp>In her research on animals, the compound has decreased cravings and anxiety without producing any psychoactive effects. But she’s not sure why, exactly, it’s working. So at the same time, she’s orchestrating studies to delve into the biology that underlies addiction.\u003c/p>\n\u003cp>Some quick background: The neurons in the brain talk to each other through neurotransmitters such as dopamine, serotonin, and endocannabinoids. Those chemical messengers ferry information between brain cells through a synapse, which is the intersection between two neurons. Drugs like heroin are like a car crash — they damage those synapses to the point that other cars can’t get through.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Hurd’s lab is studying the wreckage through research like the experiment that one of her postdoctoral researchers, Noel Warren, is working on. Warren hits rat neurons with a compound that mimics chronic heroin use to see how synaptic plasticity — the way the brain changes the connections among neurons, forming new ones while pruning others — is different in the brain after drug use.\u003c/p>\n\u003cp>Based on her findings, Hurd has launched trials to test cannabidiol in humans — but that’s no easy task.\u003c/p>\n\u003cp>\u003cstrong>‘The Hurdles Are Enormous’\u003cbr>\n\u003c/strong>Studying cannabidiol is daunting, and not just because the brain is so complex. To use cannabidiol or any part of the cannabis plant for research, a scientist has to get a special license from the Drug Enforcement Administration, which can take years. Then, scientists have to get approval from the Food and Drug Administration to administer it to patients.\u003c/p>\n\u003cp>“The hurdles are enormous,” said Margaret Haney, a neurobiologist at Columbia University who studies cannabis use disorder and the therapeutic potential of cannabinoids in humans. Haney has to keep the cannabis used in her trials in a gun safe that’s stashed inside a freezer that’s sitting in a special room in her lab that can only be accessed with her fingerprint. That’s routine for cannabis research.\u003c/p>\n\u003cp>\u003cimg class=\" wp-image-128930 alignleft\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/medmar-800x533.jpg\" alt=\"\" width=\"423\" height=\"282\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/medmar-960x640.jpg 960w\" sizes=\"(max-width: 423px) 100vw, 423px\">And patients who are enrolled in clinical trials involving cannabis have to come to the lab of the researcher who holds a DEA license to get the drug, which isn’t always doable for individuals with serious medical conditions.\u003c/p>\n\u003cp>“Our hands are tied even though cannabidiol is not addictive,” Hurd said. But because it derives from the cannabis plant, the government classifies it as a Schedule I drug — like heroin, LSD, ecstasy, and peyote — which are considered to be harmful and have no medicinal value.\u003c/p>\n\u003cp>That means there are relatively few scientists doing research involving cannabis, and even fewer studying its potential to treat addiction or testing cannabidiol in humans. Hurd isn’t in a crowded field.\u003c/p>\n\u003cp>“There’s really not that many people that do that,” said Dr. Sachin Patel, of Vanderbilt University, who has done research with cannabis to understand how marijuana exposure early in life raises the risk of psychiatric disorders.\u003c/p>\n\u003cp>And then, there’s the issue of supply.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Our hands are tied even though cannabidiol is not addictive.'\u003ccite>Dr. Yasmin Hurd\u003c/cite>\u003c/aside>\n\u003cp>For decades, the only sanctioned source of marijuana available for U.S. research was the University of Mississippi, which held an exclusive contract with the federal government.\u003c/p>\n\u003cp>“If you’re trying to do a clinical trial and you need cannabidiol, it’s actually quite difficult to get the types of cannabis needed to do the research,” said Patel.\u003c/p>\n\u003cp>Hurd said the restricted supply has made it all but impossible for her to study the specific formulations of cannabidiol she suspects would be the most therapeutic.\u003c/p>\n\u003cp>She is currently running Phase 2 clinical trials in New York to test cannabidiol’s ability to reduce cravings in people addicted to heroin. And she’s initiating similar studies to test cannabidiol soon in Canada and Jamaica.\u003c/p>\n\u003caside class=\"pullquote alignright\">'[T]he process has felt painstakingly slow when people are dying so quickly.'\u003c/aside>\n\u003cp>But for Hurd, the process has felt painstakingly slow when people are dying so quickly. An estimated 63,600 people died of drug overdoses in 2016. Two-thirds of those deaths were caused by opioids.\u003c/p>\n\u003cp>Hurd is frustrated by how both the government is grappling with the crisis. It’s paled in comparison to the response to the Zika virus and other public health concerns in recent years, she said.\u003c/p>\n\u003cp>“People swarmed to do something. That did not happen with the opioid epidemic,” Hurd said.\u003c/p>\n\u003cp>\u003cimg class=\"alignnone wp-image-435640 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/09/iStock-594036552-800x668.jpg\" alt=\"\" width=\"384\" height=\"321\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-800x668.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-160x134.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-768x641.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-1020x852.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-1180x985.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-960x801.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-240x200.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-375x313.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552-520x434.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/iStock-594036552.jpg 1895w\" sizes=\"(max-width: 384px) 100vw, 384px\">\u003c/p>\n\u003cp>Why not? Hurd blames it, in large part, on discrimination against people who are addicted to drugs. But if there were more federal funding for research, Hurd said, scientists could accelerate the search for solutions.\u003c/p>\n\u003cp>“You have to treat every epidemic the same,” she said, “whether it’s a drug epidemic or a viral epidemic.”\u003c/p>\n\u003cp>She’s quick to note that she’s not arguing that cannabidiol is a cure-all for the crisis. Hurd just wants to have enough researchers working on the problem that they can quickly say whether something works — or whether it doesn’t — and then move on.\u003c/p>\n\u003cp>Haney, the Columbia neurobiologist, echoed that frustration. The DEA said it has not rescheduled cannabis because there aren’t enough studies to show it has medical potential. But until it’s rescheduled, Haney said, those kind of large, randomized studies won’t really be feasible.\u003c/p>\n\u003cp>“We’re in a vicious cycle,” she said.\u003c/p>\n\u003cp>And dispensaries and cannabis companies in the 29 states that have already legalized medical marijuana don’t have any incentive to fund or conduct clinical trials on the medical benefits, experts say, because they’re already able to sell their products to patients without government approval.\u003c/p>\n\u003cp>“The money-making is all happening outside of any data,” Haney said.\u003c/p>\n\u003cp>So Hurd is trying to spur her fellow scientists to do as much research as possible on the potential of cannabidiol to treat opioid addiction, in a bid to build a cannabinoid consortium. She’s connected with clinicians, pharmacologists, and neuroscientists to talk about how to spur new research. And she’s working to rope in companies interested in cannabidiol, too. Without National Institutes of Health funding for such a project, she’s hopeful they’ll help fund the consortium.\u003c/p>\n\u003cp>Her goal: build an infrastructure that’s far broader than her own.\u003c/p>\n\u003cp>“I don’t need to be the only person in the room studying cannabidiol for opioid addiction,” she said. “It can’t be done with just one little Yasmin Hurd lab.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "What's In That IV Bag? Hopefully Something Other Than Saline",
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"content": "\u003cp>New research calls into question what’s in those IV bags that nearly every hospitalized patient gets. Using a different intravenous fluid instead of the usual saline greatly reduced the risk of death or kidney damage, two large studies found.\u003c/p>\n\u003cp>The difference could mean 50,000 to 70,000 fewer deaths and 100,000 fewer cases of kidney failure each year in the U.S., researchers estimate. Some doctors are hoping the results will persuade more \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/03/09/premier-hospitals-are-promoting-unproven-alternative-therapies/\" target=\"_blank\" rel=\"noopener\">hospitals\u003c/a> to switch.[contextly_sidebar id=\"0jhqLe7SiU2Eb27aQUWnipt3zwitsKUi\"]\u003c/p>\n\u003cp>“We’ve been sounding the alarm for 20 years” about possible harms from saline, said Dr. John Kellum, a critical care specialist at the University of Pittsburgh. “It’s purely inertia” that prevents a change, he said.\u003c/p>\n\u003cp>Kellum had no role in the studies, which were discussed Tuesday at a critical care conference in San Antonio and published by the New England Journal of Medicine. Federal grants helped pay for the work.[contextly_sidebar id=\"z39OU3j4iEAklNQ4ejamioZfGewR34gT\"]\u003c/p>\n\u003cp>IVs are one of the most common things in health care. They are used to prevent dehydration, maintain blood pressure or give patients medicines or nutrients if they can’t eat.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Many suppliers make both types, so switching should not be hard or expensive.'\u003c/aside>\n\u003cp>Saline — salt dissolved in water — has been the most widely used fluid in the U.S. for more than a century even as evidence has emerged that it can harm kidneys, especially when used a lot.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Other IV solutions called balanced fluids include saline but also contain potassium and other things that make them more like plasma, the clear part of blood. They’re widely used in Europe and Australia.\u003c/p>\n\u003cp>The studies involved 28,000 patients at Vanderbilt University who were given IVs of saline or a balanced fluid. For every 100 people on balanced fluids, there was one fewer death or severe kidney problem.[contextly_sidebar id=\"sUu4YOGKN2sP1Zqyc3nVUiyRVy3jB58L\"]\u003c/p>\n\u003cp>Since there are about 30 million people hospitalized in the U.S. alone each year, “there are tens or hundreds of thousands of patients who would be spared death or severe kidney problems by using balanced fluids instead of saline,” said one study leader, Vanderbilt’s Dr. Matthew Semler.\u003c/p>\n\u003cp>After seeing the results two months ago, Vanderbilt hospital officials decided to primarily use balanced fluids. The University of Pittsburgh also has largely switched to them, Kellum said.\u003c/p>\n\u003cp>The fluids cost about the same — a dollar or two per IV — and many suppliers make both types, so switching should not be hard or expensive, doctors said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>IV fluids have been in the news since Hurricane Maria hit Puerto Rico last fall, shutting down electricity to three plants owned by Baxter International, one of the biggest makers of these fluids. The shortage has eased, but some supply issues remain.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>New research calls into question what’s in those IV bags that nearly every hospitalized patient gets. Using a different intravenous fluid instead of the usual saline greatly reduced the risk of death or kidney damage, two large studies found.\u003c/p>\n\u003cp>The difference could mean 50,000 to 70,000 fewer deaths and 100,000 fewer cases of kidney failure each year in the U.S., researchers estimate. Some doctors are hoping the results will persuade more \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/03/09/premier-hospitals-are-promoting-unproven-alternative-therapies/\" target=\"_blank\" rel=\"noopener\">hospitals\u003c/a> to switch.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“We’ve been sounding the alarm for 20 years” about possible harms from saline, said Dr. John Kellum, a critical care specialist at the University of Pittsburgh. “It’s purely inertia” that prevents a change, he said.\u003c/p>\n\u003cp>Kellum had no role in the studies, which were discussed Tuesday at a critical care conference in San Antonio and published by the New England Journal of Medicine. Federal grants helped pay for the work.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>IVs are one of the most common things in health care. They are used to prevent dehydration, maintain blood pressure or give patients medicines or nutrients if they can’t eat.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Many suppliers make both types, so switching should not be hard or expensive.'\u003c/aside>\n\u003cp>Saline — salt dissolved in water — has been the most widely used fluid in the U.S. for more than a century even as evidence has emerged that it can harm kidneys, especially when used a lot.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Other IV solutions called balanced fluids include saline but also contain potassium and other things that make them more like plasma, the clear part of blood. They’re widely used in Europe and Australia.\u003c/p>\n\u003cp>The studies involved 28,000 patients at Vanderbilt University who were given IVs of saline or a balanced fluid. For every 100 people on balanced fluids, there was one fewer death or severe kidney problem.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Since there are about 30 million people hospitalized in the U.S. alone each year, “there are tens or hundreds of thousands of patients who would be spared death or severe kidney problems by using balanced fluids instead of saline,” said one study leader, Vanderbilt’s Dr. Matthew Semler.\u003c/p>\n\u003cp>After seeing the results two months ago, Vanderbilt hospital officials decided to primarily use balanced fluids. The University of Pittsburgh also has largely switched to them, Kellum said.\u003c/p>\n\u003cp>The fluids cost about the same — a dollar or two per IV — and many suppliers make both types, so switching should not be hard or expensive, doctors said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>IV fluids have been in the news since Hurricane Maria hit Puerto Rico last fall, shutting down electricity to three plants owned by Baxter International, one of the biggest makers of these fluids. The shortage has eased, but some supply issues remain.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"581\" height=\"326\" src=\"https://www.youtube.com/embed/yiglpsqv5ik\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Ten years ago at my pediatric clinic in San Francisco, teachers, social workers and parents were bringing me child after child with concerns of ADHD.\u003c/p>\n\u003cp>As I examined my patients, I noticed that the highest rate of behavioral problems was occurring in the kids whose parents had drug addictions or mental illness, or those who were subject to violence at home.\u003c/p>\n\u003cp>When I dug into the science, what I found was that for most of these kids, the problem wasn’t run of the mill ADHD. For most of my kids the real problem is what the American Academy of Pediatrics now recognizes as “toxic stress.”[contextly_sidebar id=\"PYT3p5XM48uhTDQbk48cJ0IOP5aQaQuB\"]\u003c/p>\n\u003cp>Toxic stress affects white kids, black and brown kids, rich, poor, urban, rural … it can affect anyone and it can happen anywhere.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ultimately, it all boils down to our flight-or-fight response – what happens in our bodies when we experience something scary. But, when activated too often – like with repeated abuse, neglect or parental addiction – it can change the structure and function of children’s developing brains.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Only 4 percent of pediatricians in the U.S. are screening for toxic stress.'\u003c/aside>\n\u003cp>It can affect hormones, the immune system, even the way DNA is read and transcribed. And it dramatically increases the risk of both behavioral and health problems in childhood and in adulthood.\u003c/p>\n\u003cp>But right now, only 4 percent of pediatricians in the U.S. are screening for toxic stress. Most haven’t received any training on how to identify kids who are at risk.\u003c/p>\n\u003cp>This has to change.\u003c/p>\n\u003cp>Too many children with behavioral symptoms of toxic stress are being labeled with ADHD and given stimulants without any identification of the root cause. Many kids show no behavioral symptoms at all. Yet they are still more than twice as likely to go on to develop asthma, autoimmune disease, heart disease and cancer – and their life expectancy can be cut short by decades.[contextly_sidebar id=\"XCU75OyFv9SQgCGmJSKjDF77OmW3l8Yr\"]\u003c/p>\n\u003cp>More than 34 million American children have had at least one adverse childhood experience like abuse or neglect — we need every medical professional in this country to be equipped with the right tools for universal screening.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>When identified early, doctors, educators and caregivers can help reverse the biological effects of childhood trauma. Together, we can give every child a shot at a healthy life.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ultimately, it all boils down to our flight-or-fight response – what happens in our bodies when we experience something scary. But, when activated too often – like with repeated abuse, neglect or parental addiction – it can change the structure and function of children’s developing brains.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Only 4 percent of pediatricians in the U.S. are screening for toxic stress.'\u003c/aside>\n\u003cp>It can affect hormones, the immune system, even the way DNA is read and transcribed. And it dramatically increases the risk of both behavioral and health problems in childhood and in adulthood.\u003c/p>\n\u003cp>But right now, only 4 percent of pediatricians in the U.S. are screening for toxic stress. Most haven’t received any training on how to identify kids who are at risk.\u003c/p>\n\u003cp>This has to change.\u003c/p>\n\u003cp>Too many children with behavioral symptoms of toxic stress are being labeled with ADHD and given stimulants without any identification of the root cause. Many kids show no behavioral symptoms at all. Yet they are still more than twice as likely to go on to develop asthma, autoimmune disease, heart disease and cancer – and their life expectancy can be cut short by decades.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>More than 34 million American children have had at least one adverse childhood experience like abuse or neglect — we need every medical professional in this country to be equipped with the right tools for universal screening.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>When identified early, doctors, educators and caregivers can help reverse the biological effects of childhood trauma. Together, we can give every child a shot at a healthy life.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>We spend a lot of time talking to Alexa and Siri. Imagine if such artificial personalities were put inside a cute, adorable robot. That's what Alexander Reben has done. The artist created what he saw as the perfect interview machine to see how much he could get people to reveal to the robot.\u003c/p>\n\u003cp>Reben's experiments with human robot interactions began when he was working on his master's degree in robotics at MIT. He built a robot called \u003ca href=\"http://resenv.media.mit.edu/Boxie/\" target=\"_blank\" rel=\"noopener\">Boxie\u003c/a>. It was made of cardboard, about the size of a microwave oven, and rolled around like a toy tank.[contextly_sidebar id=\"yz0kM6ZG84eg4i4rxTL7lsT0kMn9aLm9\"]\u003c/p>\n\u003cp>If you walked into the lab at MIT, Boxie would approach with its big, round black eyes wide open and ask you for help getting upstairs or going down the hall.\u003c/p>\n\u003cp>Reben wanted to see how many people would help the robot. He wondered, could you build cheaper robots without legs that could get around with help from humans?\u003c/p>\n\u003cp>But, one day, something happened that would change the course of Reben's work.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The robot was just a means to get closer to myself at a really critical moment in my life.'\u003ccite>Judith Helfand\u003c/cite>\u003c/aside>\n\u003cp>It started with a man walking into the lab and Boxie rolling up to greet him. \"I saw him from a distance, laying on the carpet in the middle of the lab talking to this robot on the ground,\" Reben says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The man began to share his troubles with Boxie. He had never been to Boston before and he'd come to take part in the marathon. The man \"just started talking to this thing like it was another person,\" Reben says.\u003c/p>\n\u003cp>The man told the robot that he was supposed to go to Munich, but his flight was canceled because of a volcanic eruption in Iceland.\u003c/p>\n\u003cp>The conversation was a revelation for Reben. He realized that the characteristics that made people want to help Boxie also seduced them into talking with the robot.\u003c/p>\n\u003cp>After all, it was cute and seemed vulnerable.\u003c/p>\n\u003cp>Reben teamed up with another artist and filmmaker, Brent Hoff, to see whether they could design a robot that would make people want to open up. They carved a smile into its face. \"It's the perfect smile. It's kind of a Mona Lisa smile,\" Hoff says. \"It's open and engaging to make sure [it] was as nonjudgmental and nonthreatening as possible.\"[contextly_sidebar id=\"2iIvqmnB8RUBK8Dpjga3ECr8rh8Wtlbk\"]\u003c/p>\n\u003cp>They gave it the sweet voice of Hoff's 8-year-old son. And they taped him asking carefully chosen questions. \"There was some consideration of what are the deepest, most important questions we have as people,\" Hoff says.\u003c/p>\n\u003cp>It asked things like, \"Who do you love most in the world?\" or \"If you could give someone any gift, what would it be?\"\u003c/p>\n\u003cp>And it had a camera and a recorder inside it to catch the answers. They called the new robot \u003ca href=\"http://areben.com/project/blabdroid/\" target=\"_blank\" rel=\"noopener\">BlabDroid\u003c/a>.\u003c/p>\n\u003cp>\"The idea,\" says Hoff, \"is that there is not as much judgment in a robot asking you a question as a journalist\" would.\u003c/p>\n\u003cp>Hoff says he doesn't know for sure whether that's true, but he wanted to find out. And so did I.\u003c/p>\n\u003cp>We set up a loose experiment. I would ask people the same questions as BlabDroid and — like the robot — there wouldn't be any follow-up questions. We tried the experiment a few times: once at an art opening and once at the Exploratorium, a science museum in San Francisco; we also listened to responses BlabDroid had collected at the Tribeca Film Festival in New York City.\u003c/p>\n\u003cp>You can click on the audio below to listen to the two examples. Try to guess whether the person was talking to me or the robot before you read further.\u003cbr>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/583682556/588054239\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/583682556/588055297\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\nThe first one is Nate Mazur, who was asked, \"Who do you love most in the world?\" He replies, \"My wife.\" Mazur opens up about the wonders of their relationship. He says he loves her most because of his \"ability to be with her, to be present with her. To respond and interact. ... She makes this a better world,\" he says.\u003c/p>\n\u003cp>The second example was Judith Helfand. She was asked, \"If you could give someone any gift, what would it be?\" She broke into tears as she spoke about her dying mother.\u003c/p>\n\u003cp>\"I would give my mother the gift of not worrying about me before she dies,\" Helfand says. \"She wants me to lose a ton of weight and get really, really healthy. And she needs to see that before she dies ... and I wish I could give her that and I'm not positive I can.\"\u003c/p>\n\u003cp>Both the answers are sincere and from the heart. Mazur spoke to me and Helfand was talking to BlabDroid.\u003c/p>\n\u003cp>Helfand found something satisfying about talking to the machine. \"The robot was just a means to get closer to myself at a really critical moment in my life,\" she says.\u003c/p>\n\u003cp>It's been over two years since her mother died. Helfand lost the weight, but she is struggling with her career. She thinks the robot would be helpful. \"Mediation really isn't really working for me,\" Helfand says. \"I can't seem to find the courage to sit and write down what my future plans are so that I can make them really happen.\"[contextly_sidebar id=\"0QqjSUSqTOgQ0iX4yALrApbCEjnw9Xay\"]\u003c/p>\n\u003cp>I asked \u003ca href=\"https://www.npr.org/2012/10/18/163098594/in-constant-digital-contact-we-feel-alone-together\" target=\"_blank\" rel=\"noopener\">Sherry Turkle\u003c/a>, a professor of science and technology at MIT, to listen to the responses. She couldn't tell whether people were talking to BlabDroid or me. Turkle has been studying human-machine relationships for decades.\u003c/p>\n\u003cp>She says it really doesn't take much to get humans to open up to a robot. \"We are kind of cheap dates,\" she says.\u003c/p>\n\u003cp>BlabDroid — with its sweet voice, Mona Lisa smile and probing questions — is \"pushing in us a kind of Darwinian button,\" Turkle says.\u003c/p>\n\u003cp>She says robots don't even have to be cute. In her research she found a child who vented to Apple's Siri on an iPhone. Turkle says the child would vent on the phone about her anger toward her sister and her parents \"because, in person, she tries to always play the good daughter.\"\u003c/p>\n\u003cp>Turkle says over time, the child wasn't happy.\u003c/p>\n\u003cp>\"There was almost a feeling of abandonment,\" Turkle says. \"There's no place they can go after they get the confession.\" She says robots can't offer certain very human things — like care, conversation and empathy. \"And the robot cannot do that because the robot has not had a life,\" she says.\u003c/p>\n\u003cp>The science-fiction author William Gibson once said, \"The future is already here; it's just not very evenly distributed yet.\" In Japan, robots are being used to \u003ca href=\"https://www.economist.com/news/business/21731677-around-5000-nursing-care-homes-across-country-are-testing-robots-japan-embracing\" target=\"_blank\" rel=\"noopener\">care for the elderly\u003c/a>. Men are having relationships with virtual women who exist only in a portable video game — even taking them out on dates. An American company has created \u003ca href=\"http://www.latimes.com/travel/la-tr-vegas-tipsy-robot-bar-20170704-story.html\" target=\"_blank\" rel=\"noopener\">robot bartenders\u003c/a>. In the future, perhaps they will listen to our problems.\u003c/p>\n\u003cp>Reben knows there is a downside to social robots. But he also sees a place for them in the future. He thinks a cute robot might do a better job of getting people to answer survey questions or talk about embarrassing symptoms before seeing a doctor. Reben says \"people tend to be more honest because they don't feel embarrassed telling that to something that's not human.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>As an artist, what Reben hopes to accomplish with BlabDroid is to force us to think about the implications of bringing more robots into our society knowing full well that they are coming.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit\u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\"> http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Sometimes+We+Feel+More+Comfortable+Talking+To+A+Robot&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The man began to share his troubles with Boxie. He had never been to Boston before and he'd come to take part in the marathon. The man \"just started talking to this thing like it was another person,\" Reben says.\u003c/p>\n\u003cp>The man told the robot that he was supposed to go to Munich, but his flight was canceled because of a volcanic eruption in Iceland.\u003c/p>\n\u003cp>The conversation was a revelation for Reben. He realized that the characteristics that made people want to help Boxie also seduced them into talking with the robot.\u003c/p>\n\u003cp>After all, it was cute and seemed vulnerable.\u003c/p>\n\u003cp>Reben teamed up with another artist and filmmaker, Brent Hoff, to see whether they could design a robot that would make people want to open up. They carved a smile into its face. \"It's the perfect smile. It's kind of a Mona Lisa smile,\" Hoff says. \"It's open and engaging to make sure [it] was as nonjudgmental and nonthreatening as possible.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>They gave it the sweet voice of Hoff's 8-year-old son. And they taped him asking carefully chosen questions. \"There was some consideration of what are the deepest, most important questions we have as people,\" Hoff says.\u003c/p>\n\u003cp>It asked things like, \"Who do you love most in the world?\" or \"If you could give someone any gift, what would it be?\"\u003c/p>\n\u003cp>And it had a camera and a recorder inside it to catch the answers. They called the new robot \u003ca href=\"http://areben.com/project/blabdroid/\" target=\"_blank\" rel=\"noopener\">BlabDroid\u003c/a>.\u003c/p>\n\u003cp>\"The idea,\" says Hoff, \"is that there is not as much judgment in a robot asking you a question as a journalist\" would.\u003c/p>\n\u003cp>Hoff says he doesn't know for sure whether that's true, but he wanted to find out. And so did I.\u003c/p>\n\u003cp>We set up a loose experiment. I would ask people the same questions as BlabDroid and — like the robot — there wouldn't be any follow-up questions. We tried the experiment a few times: once at an art opening and once at the Exploratorium, a science museum in San Francisco; we also listened to responses BlabDroid had collected at the Tribeca Film Festival in New York City.\u003c/p>\n\u003cp>You can click on the audio below to listen to the two examples. Try to guess whether the person was talking to me or the robot before you read further.\u003cbr>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/583682556/588054239\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/583682556/588055297\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\nThe first one is Nate Mazur, who was asked, \"Who do you love most in the world?\" He replies, \"My wife.\" Mazur opens up about the wonders of their relationship. He says he loves her most because of his \"ability to be with her, to be present with her. To respond and interact. ... She makes this a better world,\" he says.\u003c/p>\n\u003cp>The second example was Judith Helfand. She was asked, \"If you could give someone any gift, what would it be?\" She broke into tears as she spoke about her dying mother.\u003c/p>\n\u003cp>\"I would give my mother the gift of not worrying about me before she dies,\" Helfand says. \"She wants me to lose a ton of weight and get really, really healthy. And she needs to see that before she dies ... and I wish I could give her that and I'm not positive I can.\"\u003c/p>\n\u003cp>Both the answers are sincere and from the heart. Mazur spoke to me and Helfand was talking to BlabDroid.\u003c/p>\n\u003cp>Helfand found something satisfying about talking to the machine. \"The robot was just a means to get closer to myself at a really critical moment in my life,\" she says.\u003c/p>\n\u003cp>It's been over two years since her mother died. Helfand lost the weight, but she is struggling with her career. She thinks the robot would be helpful. \"Mediation really isn't really working for me,\" Helfand says. \"I can't seem to find the courage to sit and write down what my future plans are so that I can make them really happen.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>I asked \u003ca href=\"https://www.npr.org/2012/10/18/163098594/in-constant-digital-contact-we-feel-alone-together\" target=\"_blank\" rel=\"noopener\">Sherry Turkle\u003c/a>, a professor of science and technology at MIT, to listen to the responses. She couldn't tell whether people were talking to BlabDroid or me. Turkle has been studying human-machine relationships for decades.\u003c/p>\n\u003cp>She says it really doesn't take much to get humans to open up to a robot. \"We are kind of cheap dates,\" she says.\u003c/p>\n\u003cp>BlabDroid — with its sweet voice, Mona Lisa smile and probing questions — is \"pushing in us a kind of Darwinian button,\" Turkle says.\u003c/p>\n\u003cp>She says robots don't even have to be cute. In her research she found a child who vented to Apple's Siri on an iPhone. Turkle says the child would vent on the phone about her anger toward her sister and her parents \"because, in person, she tries to always play the good daughter.\"\u003c/p>\n\u003cp>Turkle says over time, the child wasn't happy.\u003c/p>\n\u003cp>\"There was almost a feeling of abandonment,\" Turkle says. \"There's no place they can go after they get the confession.\" She says robots can't offer certain very human things — like care, conversation and empathy. \"And the robot cannot do that because the robot has not had a life,\" she says.\u003c/p>\n\u003cp>The science-fiction author William Gibson once said, \"The future is already here; it's just not very evenly distributed yet.\" In Japan, robots are being used to \u003ca href=\"https://www.economist.com/news/business/21731677-around-5000-nursing-care-homes-across-country-are-testing-robots-japan-embracing\" target=\"_blank\" rel=\"noopener\">care for the elderly\u003c/a>. Men are having relationships with virtual women who exist only in a portable video game — even taking them out on dates. An American company has created \u003ca href=\"http://www.latimes.com/travel/la-tr-vegas-tipsy-robot-bar-20170704-story.html\" target=\"_blank\" rel=\"noopener\">robot bartenders\u003c/a>. In the future, perhaps they will listen to our problems.\u003c/p>\n\u003cp>Reben knows there is a downside to social robots. But he also sees a place for them in the future. He thinks a cute robot might do a better job of getting people to answer survey questions or talk about embarrassing symptoms before seeing a doctor. Reben says \"people tend to be more honest because they don't feel embarrassed telling that to something that's not human.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As an artist, what Reben hopes to accomplish with BlabDroid is to force us to think about the implications of bringing more robots into our society knowing full well that they are coming.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit\u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\"> http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Sometimes+We+Feel+More+Comfortable+Talking+To+A+Robot&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Only about 50 percent of adolescents with depression \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11430842\" target=\"_blank\" rel=\"noopener\">get diagnosed\u003c/a> before reaching adulthood. And as many as 2 in 3 depressed teens don't get the care that could help them.\u003c/p>\n\u003cp>\"It's a huge problem,\" says \u003ca href=\"https://www.columbiapsychiatry.org/profile/rachel-zuckerbrot-md\" target=\"_blank\" rel=\"noopener\">Dr. Rachel Zuckerbrot\u003c/a>, a board-certified child and adolescent psychiatrist and associate professor at Columbia University.[contextly_sidebar id=\"efpc6ttGwJCppmSgRyb1Z8vZfGFJ86rV\"]\u003c/p>\n\u003cp>To address this divide, the American Academy of Pediatrics has\u003ca href=\"http://pediatrics.aappublications.org/content/pediatrics/120/5/e1299.full.pdf?ck=nck\"> issued\u003c/a> updated guidelines this week that call for universal screening for depression.\u003c/p>\n\u003cp>\"What we're endorsing is that everyone, 12 and up, be screened ... at least once a year,\" Zuckerbrot says. The screening, she says, could be done during a well-visit, a sports' physical or during another office visit.\u003c/p>\n\u003cp>Zuckerbrot helped write the guidelines, which have been in development for a while. The U.S. Preventive Services Task Force also \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/depression-in-children-and-adolescents-screening1\">recommends\u003c/a> depression screening, and many pediatricians have already woven the screenings into their practices.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Teenagers are often more honest when they're not looking somebody in the face who's asking questions,\" about their emotional health Zuckerbrot says. So, most pediatricians use a self-reported questionnaire that teens fill out themselves, either on an electronic device or on paper.[contextly_sidebar id=\"EqP0dmqjnqMOlo0gJdMgB0IK322g3bSk\"]\u003c/p>\n\u003cp>\"It's an opportunity for the adolescent to answer questions about themselves privately,\" she says.\u003c/p>\n\u003cp>The questionnaires contain a range of questions. For instance, one version, \u003ca href=\"http://www.cqaimh.org/pdf/tool_phq2.pdf\">asks\u003c/a>: 'Over the past two weeks, how often have you been bothered by any of the following problems: feeling down, depressed or hopeless? Or, little interest or pleasure in doing things?' Teens are also asked questions such as, 'Are you having difficulty with sleep, either too much or too little?' 'Any problems with eating?'\u003c/p>\n\u003cp>The new recommendations also call for families with a depressed teen to develop a safety plan to restrict the young person's access to lethal means of harm. Suicide is a leading cause of death for children aged 10 to 17, and \"adolescent suicide risk is strongly associated with firearm availability,\" \u003ca href=\"http://pediatrics.aappublications.org/content/130/5/e1416.full\" target=\"_blank\" rel=\"noopener\">according\u003c/a> to an AAP report.\u003c/p>\n\u003cp>There's growing awareness in the U.S. of the need for young people to have good access to mental health care\u003cstrong>, \u003c/strong>says \u003ca href=\"https://www.linkedin.com/in/douglas-newton-md-mph-99544a109\" target=\"_blank\" rel=\"noopener\">Dr. Doug Newton\u003c/a>, a child psychiatrist at Kaiser Permanente in Colorado. \"As a nation this has become part of the dialogue; it increasing\"\u003c/p>\n\u003cp>\"People are aware of what's happening in our schools and the importance of mental health,\" Newton says. Kaiser Permanente has a stigma-reduction campaign called\u003ca href=\"https://share.kaiserpermanente.org/article/find-your-words-to-fight-stigma-around-depression/\" target=\"_blank\" rel=\"noopener\"> Find Your Words\u003c/a>.\u003c/p>\n\u003cp>\"Stigma is a huge challenge,\" he says, \"specifically for adolescents. Often times they're not coming in to get help because of the stigma attached.\"\u003c/p>\n\u003cp>It's not easy to talk about depression, yet the problem is fairly common. During the teenage years, there's about a 20 percent [chance] of having depression or anxiety, research suggests.\u003c/p>\n\u003cp>\"It's highly prevalent,\" Newton says. The goal of the \"Find Your Words\" campaign is to help make depression easier for everyone to talk about.\u003c/p>\n\u003cp>Another challenge to diagnosis is that families often don't detect depression, or they confuse it for something else.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Sometimes teens are acting out or misbehaving,\" Zuckerbrot says. They're seen as being hostile or bad. \"When, instead, they're really suffering from depression.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\">http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Pediatricians+Call+For+Universal+Depression+Screening+For+Teens&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Only about 50 percent of adolescents with depression \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11430842\" target=\"_blank\" rel=\"noopener\">get diagnosed\u003c/a> before reaching adulthood. And as many as 2 in 3 depressed teens don't get the care that could help them.\u003c/p>\n\u003cp>\"It's a huge problem,\" says \u003ca href=\"https://www.columbiapsychiatry.org/profile/rachel-zuckerbrot-md\" target=\"_blank\" rel=\"noopener\">Dr. Rachel Zuckerbrot\u003c/a>, a board-certified child and adolescent psychiatrist and associate professor at Columbia University.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>To address this divide, the American Academy of Pediatrics has\u003ca href=\"http://pediatrics.aappublications.org/content/pediatrics/120/5/e1299.full.pdf?ck=nck\"> issued\u003c/a> updated guidelines this week that call for universal screening for depression.\u003c/p>\n\u003cp>\"What we're endorsing is that everyone, 12 and up, be screened ... at least once a year,\" Zuckerbrot says. The screening, she says, could be done during a well-visit, a sports' physical or during another office visit.\u003c/p>\n\u003cp>Zuckerbrot helped write the guidelines, which have been in development for a while. The U.S. Preventive Services Task Force also \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/depression-in-children-and-adolescents-screening1\">recommends\u003c/a> depression screening, and many pediatricians have already woven the screenings into their practices.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Teenagers are often more honest when they're not looking somebody in the face who's asking questions,\" about their emotional health Zuckerbrot says. So, most pediatricians use a self-reported questionnaire that teens fill out themselves, either on an electronic device or on paper.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"It's an opportunity for the adolescent to answer questions about themselves privately,\" she says.\u003c/p>\n\u003cp>The questionnaires contain a range of questions. For instance, one version, \u003ca href=\"http://www.cqaimh.org/pdf/tool_phq2.pdf\">asks\u003c/a>: 'Over the past two weeks, how often have you been bothered by any of the following problems: feeling down, depressed or hopeless? Or, little interest or pleasure in doing things?' Teens are also asked questions such as, 'Are you having difficulty with sleep, either too much or too little?' 'Any problems with eating?'\u003c/p>\n\u003cp>The new recommendations also call for families with a depressed teen to develop a safety plan to restrict the young person's access to lethal means of harm. Suicide is a leading cause of death for children aged 10 to 17, and \"adolescent suicide risk is strongly associated with firearm availability,\" \u003ca href=\"http://pediatrics.aappublications.org/content/130/5/e1416.full\" target=\"_blank\" rel=\"noopener\">according\u003c/a> to an AAP report.\u003c/p>\n\u003cp>There's growing awareness in the U.S. of the need for young people to have good access to mental health care\u003cstrong>, \u003c/strong>says \u003ca href=\"https://www.linkedin.com/in/douglas-newton-md-mph-99544a109\" target=\"_blank\" rel=\"noopener\">Dr. Doug Newton\u003c/a>, a child psychiatrist at Kaiser Permanente in Colorado. \"As a nation this has become part of the dialogue; it increasing\"\u003c/p>\n\u003cp>\"People are aware of what's happening in our schools and the importance of mental health,\" Newton says. Kaiser Permanente has a stigma-reduction campaign called\u003ca href=\"https://share.kaiserpermanente.org/article/find-your-words-to-fight-stigma-around-depression/\" target=\"_blank\" rel=\"noopener\"> Find Your Words\u003c/a>.\u003c/p>\n\u003cp>\"Stigma is a huge challenge,\" he says, \"specifically for adolescents. Often times they're not coming in to get help because of the stigma attached.\"\u003c/p>\n\u003cp>It's not easy to talk about depression, yet the problem is fairly common. During the teenage years, there's about a 20 percent [chance] of having depression or anxiety, research suggests.\u003c/p>\n\u003cp>\"It's highly prevalent,\" Newton says. The goal of the \"Find Your Words\" campaign is to help make depression easier for everyone to talk about.\u003c/p>\n\u003cp>Another challenge to diagnosis is that families often don't detect depression, or they confuse it for something else.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Sometimes teens are acting out or misbehaving,\" Zuckerbrot says. They're seen as being hostile or bad. \"When, instead, they're really suffering from depression.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\">http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Pediatricians+Call+For+Universal+Depression+Screening+For+Teens&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>It's pretty extraordinary for people in their 80s and 90s to keep the same sharp memory as someone several decades younger, and now scientists are peeking into the brains of these \"superagers\" to uncover their secret.\u003c/p>\n\u003cp>The work is the flip side of the disappointing hunt for new drugs to fight or prevent Alzheimer's disease.\u003c/p>\n\u003cp>Instead, \"why don't we figure out what it is we might need to do to maximize our memory?\" said neuroscientist Emily Rogalski, who leads the SuperAging study at Northwestern University in Chicago.\u003c/p>\n\u003cp>Parts of the brain shrink with age, one of the reasons why most [contextly_sidebar id=\"G3H8QC9o82TylnWZAr296D2zVHqEWAob\"]people experience a gradual slowing of at least some types of memory late in life, even if they avoid diseases like Alzheimer's.\u003c/p>\n\u003cp>But it turns out that superagers' brains aren't shrinking nearly as fast as their peers'. And autopsies of the first superagers to die during the study show they harbor a lot more of a special kind of nerve cell in a deep brain region that's important for attention, Rogalski told a recent meeting of the American Association for the Advancement of Science.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These elite elders are \"more than just an oddity or a rarity,\" said neuroscientist Molly Wagster of the National Institute on Aging, which helps fund the research. \"There's the potential for learning an enormous amount and applying it to the rest of us, and even to those who may be on a trajectory for some type of neurodegenerative disease.\"\u003c/p>\n\u003cp>What does it take to be a superager? A youthful brain in the body of someone 80 or older. Rogalski's team has given a battery of tests to more than 1,000 people who thought they'd qualify, and only about 5 percent pass. The key \u003ca href=\"https://ww2.kqed.org/futureofyou/2018/02/07/a-tiny-pulse-of-electricity-to-the-brain-can-boost-memory/\" target=\"_blank\" rel=\"noopener\">memory challenge\u003c/a>: Listen to 15 unrelated words, and a half-hour later recall at least nine. That's the norm for 50-year-olds, but the average 80-year-old recalls five. Some superagers remember them all.[contextly_sidebar id=\"CmEYEjCmwB2h2qN7hBJIIlooU2YvQ8dj\"]\u003c/p>\n\u003cp>\"It doesn't mean you're any smarter,\" stressed superager William \"Bill\" Gurolnick, who turns 87 next month and joined the study two years ago.\u003c/p>\n\u003cp>Nor can he credit protective genes: Gurolnick's father developed Alzheimer's in his 50s. He thinks his own \u003ca href=\"https://ww2.kqed.org/perspectives/2018/02/12/the-memory-of-stuff/\" target=\"_blank\" rel=\"noopener\">stellar memory\u003c/a> is bolstered by keeping busy. He bikes, and plays tennis and water volleyball. He stays social through regular lunches and meetings with a men's group he co-founded.\u003c/p>\n\u003cp>\"Absolutely that's a critical factor about keeping your wits about you,\" exclaimed Gurolnick, fresh off his monthly gin game.\u003c/p>\n\u003cp>\u003cstrong>Brain Scans\u003c/strong>\u003c/p>\n\u003cp>Rogalski's superagers tend to be extroverts and report strong social networks, but otherwise they come from all walks of life, making it hard to find a common trait \u003ca href=\"https://ww2.kqed.org/forum/2017/04/11/emotions-are-a-construct-of-the-brain-says-psychologist-lisa-feldman-barrett/\" target=\"_blank\" rel=\"noopener\">for brain health\u003c/a>. Some went to college, some didn't. Some have high IQs, some are average. She's studied people who've experienced enormous trauma, including a Holocaust survivor; fitness buffs and smokers; teetotalers and those who tout a nightly martini.\u003c/p>\n\u003cp>But deep in their brains is where she's finding compelling hints that somehow, superagers are more resilient against the ravages of time.\u003c/p>\n\u003cp>Early on, brain scans showed that a superager's cortex — an outer brain layer critical for memory and other key functions — is much thicker than normal for their age. It looks more like the cortex of healthy 50- and 60-year-olds.\u003c/p>\n\u003cp>It's not clear if they were born that way. But Rogalski's team found another possible explanation: A superager's cortex doesn't shrink as fast. Over 18 months, average 80-somethings experienced more than twice the rate of loss.\u003c/p>\n\u003cp>Another clue: Deeper in the brain, that attention region is larger in superagers, too. And inside, autopsies showed that brain region was packed with unusual large, spindly neurons — a special and little understood type called von Economo neurons thought to play a role in social processing and awareness.\u003c/p>\n\u003cp>The superagers had four to five times more of those neurons than the typical octogenarian, Rogalski said — more even than the average young adult.[contextly_sidebar id=\"AJFvjFXNb2dpYXWnAkrRzU9vWHQngSNl\"]\u003c/p>\n\u003cp>The Northwestern study isn't the only attempt at unraveling long-lasting memory. At the University of California, Irvine, Dr. Claudia Kawas studies the oldest-old, people 90 and above. Some have Alzheimer's. Some have maintained excellent memory and some are in between.\u003c/p>\n\u003cp>About 40 percent of the oldest-old who showed no symptoms of dementia in life nonetheless have full-fledged signs of Alzheimer's disease\u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/08/09/lag-in-brain-donation-hampers-understanding-of-dementia-in-blacks/\" target=\"_blank\" rel=\"noopener\"> in their brains\u003c/a> at death, Kawas told the AAAS meeting.\u003c/p>\n\u003cp>Rogalski also found varying amounts of amyloid and tau, hallmark Alzheimer's proteins, in the brains of some superagers.\u003c/p>\n\u003cp>Now scientists are exploring how these people deflect damage. Maybe superagers have different pathways\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/06/obesity-can-lead-to-memory-loss/\" target=\"_blank\" rel=\"noopener\"> to brain health.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"They are living long and living well,\" Rogalski said. \"Are there modifiable things we can think about today, in our everyday lives\" to do the same?\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's pretty extraordinary for people in their 80s and 90s to keep the same sharp memory as someone several decades younger, and now scientists are peeking into the brains of these \"superagers\" to uncover their secret.\u003c/p>\n\u003cp>The work is the flip side of the disappointing hunt for new drugs to fight or prevent Alzheimer's disease.\u003c/p>\n\u003cp>Instead, \"why don't we figure out what it is we might need to do to maximize our memory?\" said neuroscientist Emily Rogalski, who leads the SuperAging study at Northwestern University in Chicago.\u003c/p>\n\u003cp>Parts of the brain shrink with age, one of the reasons why most \u003c/p>\u003cp>\u003c/p>\u003cp>people experience a gradual slowing of at least some types of memory late in life, even if they avoid diseases like Alzheimer's.\u003c/p>\n\u003cp>But it turns out that superagers' brains aren't shrinking nearly as fast as their peers'. And autopsies of the first superagers to die during the study show they harbor a lot more of a special kind of nerve cell in a deep brain region that's important for attention, Rogalski told a recent meeting of the American Association for the Advancement of Science.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These elite elders are \"more than just an oddity or a rarity,\" said neuroscientist Molly Wagster of the National Institute on Aging, which helps fund the research. \"There's the potential for learning an enormous amount and applying it to the rest of us, and even to those who may be on a trajectory for some type of neurodegenerative disease.\"\u003c/p>\n\u003cp>What does it take to be a superager? A youthful brain in the body of someone 80 or older. Rogalski's team has given a battery of tests to more than 1,000 people who thought they'd qualify, and only about 5 percent pass. The key \u003ca href=\"https://ww2.kqed.org/futureofyou/2018/02/07/a-tiny-pulse-of-electricity-to-the-brain-can-boost-memory/\" target=\"_blank\" rel=\"noopener\">memory challenge\u003c/a>: Listen to 15 unrelated words, and a half-hour later recall at least nine. That's the norm for 50-year-olds, but the average 80-year-old recalls five. Some superagers remember them all.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"It doesn't mean you're any smarter,\" stressed superager William \"Bill\" Gurolnick, who turns 87 next month and joined the study two years ago.\u003c/p>\n\u003cp>Nor can he credit protective genes: Gurolnick's father developed Alzheimer's in his 50s. He thinks his own \u003ca href=\"https://ww2.kqed.org/perspectives/2018/02/12/the-memory-of-stuff/\" target=\"_blank\" rel=\"noopener\">stellar memory\u003c/a> is bolstered by keeping busy. He bikes, and plays tennis and water volleyball. He stays social through regular lunches and meetings with a men's group he co-founded.\u003c/p>\n\u003cp>\"Absolutely that's a critical factor about keeping your wits about you,\" exclaimed Gurolnick, fresh off his monthly gin game.\u003c/p>\n\u003cp>\u003cstrong>Brain Scans\u003c/strong>\u003c/p>\n\u003cp>Rogalski's superagers tend to be extroverts and report strong social networks, but otherwise they come from all walks of life, making it hard to find a common trait \u003ca href=\"https://ww2.kqed.org/forum/2017/04/11/emotions-are-a-construct-of-the-brain-says-psychologist-lisa-feldman-barrett/\" target=\"_blank\" rel=\"noopener\">for brain health\u003c/a>. Some went to college, some didn't. Some have high IQs, some are average. She's studied people who've experienced enormous trauma, including a Holocaust survivor; fitness buffs and smokers; teetotalers and those who tout a nightly martini.\u003c/p>\n\u003cp>But deep in their brains is where she's finding compelling hints that somehow, superagers are more resilient against the ravages of time.\u003c/p>\n\u003cp>Early on, brain scans showed that a superager's cortex — an outer brain layer critical for memory and other key functions — is much thicker than normal for their age. It looks more like the cortex of healthy 50- and 60-year-olds.\u003c/p>\n\u003cp>It's not clear if they were born that way. But Rogalski's team found another possible explanation: A superager's cortex doesn't shrink as fast. Over 18 months, average 80-somethings experienced more than twice the rate of loss.\u003c/p>\n\u003cp>Another clue: Deeper in the brain, that attention region is larger in superagers, too. And inside, autopsies showed that brain region was packed with unusual large, spindly neurons — a special and little understood type called von Economo neurons thought to play a role in social processing and awareness.\u003c/p>\n\u003cp>The superagers had four to five times more of those neurons than the typical octogenarian, Rogalski said — more even than the average young adult.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The Northwestern study isn't the only attempt at unraveling long-lasting memory. At the University of California, Irvine, Dr. Claudia Kawas studies the oldest-old, people 90 and above. Some have Alzheimer's. Some have maintained excellent memory and some are in between.\u003c/p>\n\u003cp>About 40 percent of the oldest-old who showed no symptoms of dementia in life nonetheless have full-fledged signs of Alzheimer's disease\u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/08/09/lag-in-brain-donation-hampers-understanding-of-dementia-in-blacks/\" target=\"_blank\" rel=\"noopener\"> in their brains\u003c/a> at death, Kawas told the AAAS meeting.\u003c/p>\n\u003cp>Rogalski also found varying amounts of amyloid and tau, hallmark Alzheimer's proteins, in the brains of some superagers.\u003c/p>\n\u003cp>Now scientists are exploring how these people deflect damage. Maybe superagers have different pathways\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/06/obesity-can-lead-to-memory-loss/\" target=\"_blank\" rel=\"noopener\"> to brain health.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"They are living long and living well,\" Rogalski said. \"Are there modifiable things we can think about today, in our everyday lives\" to do the same?\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>It's OK for doctors to start using a kid-friendly nasal spray flu vaccine again, a federal panel said Wednesday.\u003c/p>\n\u003cp>Two years ago, the advisory group pulled its recommendation for FluMist vaccine after research found it wasn't working against swine flu, the kind of flu that was making most people sick then. But the Advisory Committee of Immunization Practices voted 12-2 Wednesday to recommend the nasal spray as an option for next winter's flu season.\u003c/p>\n\u003cp>An official from AstraZeneca, the company that makes FluMist, said the problem with the vaccine has been identified and corrected. But panel members noted there's still not good proof that FluMist works well against the swine flu bug.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The AstraZeneca product was once considered the best childhood flu vaccine on the market .’\u003c/aside>\n\u003cp>\"This is not an easy decision. It's always a challenge to make a decision with incomplete data,\" said one panel member, Dr. Edward Belongia of the Wisconsin-based Marshfield Clinic Research Foundation.\u003c/p>\n\u003cp>The panel makes its recommendations to the Centers for Disease Control and Prevention, which usually accepts the advice and sends it along as guidance to doctors, hospitals and health insurers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>FluMist is the only spray-in-the-nose vaccine on the market. It was first licensed in 2003 and is approved for healthy people ages 2 to 49. Unlike shots made from a killed virus, it is made from a live but weakened flu virus.\u003c/p>\n\u003cp>The AstraZeneca product was once considered the best childhood flu vaccine on the market and accounted for about a third of all child vaccinations. But in 2016, the committee rescinded its recommendation of FluMist after federal study results showed it provided no protection from the 2009 swine flu strain that made most people sick the previous year. It remained on the market, but for the past two winters federal officials have not been recommending that doctors give it.[contextly_sidebar id=\"Hrou1Nwf7eYT3yzBWaRGfQJaw6JOSBDA\"]\u003c/p>\n\u003cp>AstraZeneca has changed the way it tests and selects strains for the vaccine, said Dr. Raburn Mallory, a company official, speaking at the panel meeting in Atlanta. It's been difficult for researchers to check how well the revised product works, in part because in the last two years another type of flu — not swine flu — has caused most of each season's illnesses.\u003c/p>\n\u003cp>Studies have suggested that while FluMist fell down against swine flu, it has been effective against other types of flu.\u003c/p>\n\u003cp>That makes it better than nothing, panel members said. And FluMist is appealing because it is easier to give to kids who fear needles.\u003c/p>\n\u003cp>Some experts at the meeting worried the panel's decision could further damage public confidence in flu vaccines. If FluMist should fail to protect children during a bad flu season in the future, \"that's a potential disaster,\" said Dr. Sean O'Leary of the Pediatric infectious Diseases Society.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Last week, a government study found the flu shot was doing a poor job this winter. The flu vaccine changes from year to year, depending on what flu bugs are going around.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's OK for doctors to start using a kid-friendly nasal spray flu vaccine again, a federal panel said Wednesday.\u003c/p>\n\u003cp>Two years ago, the advisory group pulled its recommendation for FluMist vaccine after research found it wasn't working against swine flu, the kind of flu that was making most people sick then. But the Advisory Committee of Immunization Practices voted 12-2 Wednesday to recommend the nasal spray as an option for next winter's flu season.\u003c/p>\n\u003cp>An official from AstraZeneca, the company that makes FluMist, said the problem with the vaccine has been identified and corrected. But panel members noted there's still not good proof that FluMist works well against the swine flu bug.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The AstraZeneca product was once considered the best childhood flu vaccine on the market .’\u003c/aside>\n\u003cp>\"This is not an easy decision. It's always a challenge to make a decision with incomplete data,\" said one panel member, Dr. Edward Belongia of the Wisconsin-based Marshfield Clinic Research Foundation.\u003c/p>\n\u003cp>The panel makes its recommendations to the Centers for Disease Control and Prevention, which usually accepts the advice and sends it along as guidance to doctors, hospitals and health insurers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>FluMist is the only spray-in-the-nose vaccine on the market. It was first licensed in 2003 and is approved for healthy people ages 2 to 49. Unlike shots made from a killed virus, it is made from a live but weakened flu virus.\u003c/p>\n\u003cp>The AstraZeneca product was once considered the best childhood flu vaccine on the market and accounted for about a third of all child vaccinations. But in 2016, the committee rescinded its recommendation of FluMist after federal study results showed it provided no protection from the 2009 swine flu strain that made most people sick the previous year. It remained on the market, but for the past two winters federal officials have not been recommending that doctors give it.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>AstraZeneca has changed the way it tests and selects strains for the vaccine, said Dr. Raburn Mallory, a company official, speaking at the panel meeting in Atlanta. It's been difficult for researchers to check how well the revised product works, in part because in the last two years another type of flu — not swine flu — has caused most of each season's illnesses.\u003c/p>\n\u003cp>Studies have suggested that while FluMist fell down against swine flu, it has been effective against other types of flu.\u003c/p>\n\u003cp>That makes it better than nothing, panel members said. And FluMist is appealing because it is easier to give to kids who fear needles.\u003c/p>\n\u003cp>Some experts at the meeting worried the panel's decision could further damage public confidence in flu vaccines. If FluMist should fail to protect children during a bad flu season in the future, \"that's a potential disaster,\" said Dr. Sean O'Leary of the Pediatric infectious Diseases Society.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Last week, a government study found the flu shot was doing a poor job this winter. The flu vaccine changes from year to year, depending on what flu bugs are going around.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>https://www.youtube.com/watch?v=cp8SlAZhGbk&ab_channel=UCSanFrancisco%28UCSF%29\u003c/p>\n\u003cp>Let there be light -- in the battle against cancer cells.\u003c/p>\n\u003cp>The stunning images above, captured using high-speed laser microscopy, shows a cancer cell isolated on a coverslip, trapped within \"walls\" of blue light. \u003c/p>\n\u003cp>Scientists created this cage by inserting a light-sensitive protein from plants into the cell, so that any contact with the light caused the protein to come apart, and the cell's structural \"scaffolding\" (the white lines within the cell) to collapse.\u003c/p>\n\u003cp>This makes it impossible for the cell to continue moving in the same direction. In response, the cell turns and tries a different route, with the same result. Thus, the cell is stopped dead in its tracks. The process of manipulating cells with light is called optogenetics.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Photo-inactivation lets us turn proteins off and back on in living cells in real time, and do so with much more spatial accuracy than has been possible before,” said Torsten Wittmann, a UCSF professor who led the study on the technique.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While the technique is not going to be used in people any time soon, disrupting this isolated cell's ability to migrate is teaching researchers about new ways they might prevent metastatic cancer from spreading in patients. The same process can also be used to study a host of functions in other types of cells, as well.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>https://www.youtube.com/watch?v=cp8SlAZhGbk&ab_channel=UCSanFrancisco%28UCSF%29\u003c/p>\n\u003cp>Let there be light -- in the battle against cancer cells.\u003c/p>\n\u003cp>The stunning images above, captured using high-speed laser microscopy, shows a cancer cell isolated on a coverslip, trapped within \"walls\" of blue light. \u003c/p>\n\u003cp>Scientists created this cage by inserting a light-sensitive protein from plants into the cell, so that any contact with the light caused the protein to come apart, and the cell's structural \"scaffolding\" (the white lines within the cell) to collapse.\u003c/p>\n\u003cp>This makes it impossible for the cell to continue moving in the same direction. In response, the cell turns and tries a different route, with the same result. Thus, the cell is stopped dead in its tracks. The process of manipulating cells with light is called optogenetics.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Photo-inactivation lets us turn proteins off and back on in living cells in real time, and do so with much more spatial accuracy than has been possible before,” said Torsten Wittmann, a UCSF professor who led the study on the technique.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While the technique is not going to be used in people any time soon, disrupting this isolated cell's ability to migrate is teaching researchers about new ways they might prevent metastatic cancer from spreading in patients. The same process can also be used to study a host of functions in other types of cells, as well.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>If the Russian psychologist Ivan Pavlov were alive today, what would he say about smartphones? He might not think of them as phones at all, but instead as remarkable tools for understanding how technology can manipulate our brains.\u003c/p>\n\u003cp>Pavlov's own findings — from \u003ca href=\"https://www.nobelprize.org/educational/medicine/pavlov/readmore.html\" target=\"_blank\" rel=\"noopener\">experiments\u003c/a> he did more than a century ago, involving food, buzzers and slobbering dogs — offer key insights, into why our phones have become almost an extension of our bodies, modern researchers say. The findings also provide clues to how we can break our dependence.\u003c/p>\n\u003cp>Pavlov originally set off to study canine digestion. But one day, he noticed something peculiar while feeding his dogs. If he played a sound — like a metronome or buzzer — before mealtimes, eventually the sound started to have a special meaning for the animals. It meant food was coming! The dogs actually started drooling when they heard the sound, even if no food was around.[contextly_sidebar id=\"WFvp0A8BvWC683stKdY7NtFgZFPpmCHR\"]\u003c/p>\n\u003cp>Hearing the buzzer had become pleasurable.\u003c/p>\n\u003cp>That's exactly what's happening with smartphones, says David Greenfield, a \u003ca href=\"http://virtual-addiction.com/about-us/\" target=\"_blank\" rel=\"noopener\">psychologist\u003c/a> and assistant clinical professor of psychiatry at the University of Connecticut.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When we hear a ding or little ditty alerting us to a new text, email or Facebook post, cells in our brains likely release dopamine — one of the chemical transmitters in the brain's reward circuitry. That dopamine makes us feel pleasure, Greenfield says.\u003c/p>\n\u003cp>\"That ping is telling us there is some type of reward there, waiting for us,\" Greenfield says.\u003c/p>\n\u003cp>Over time, that ping can become more powerful than the reward itself. Research on animals suggests dopamine levels in the brain can be twice as high when you anticipate the reward as when you actually receive it.\u003c/p>\n\u003cp>In other words, just hearing the notification can be more pleasurable than the text, email or tweet. \"Smartphone notifications have turned us all into Pavlov's dogs,\" Greenfield says.\u003c/p>\n\u003cp>\u003cstrong>Signs you might need to cut back\u003c/strong>\u003c/p>\n\u003cp>The average adult checks their phone 50 to 300 times each day, Greenfield says. And smartphones use psychological tricks that encourage our continued high usage — some of the same tricks slot machines use to hook gamblers.[contextly_sidebar id=\"oJLVZ8oFYDN98pI8tihIPWKg11UGF8v0\"]\u003c/p>\n\u003cp>\"For example, every time you look at your phone, you don't know what you're going to find — how relevant or desirable a message is going to be,\" Greenfield says. \"So you keep checking it over and over again because every once in a while, there's something good there.\" (This is called a variable ratio schedule of reinforcement. Animal studies suggest it makes dopamine skyrocket in the brain's reward circuity and is possibly one reason people keep playing slot machines.)\u003c/p>\n\u003cp>A growing number of doctors and psychologists are concerned about our relationship with the phone. There's a debate about what to call the problem. Some say \"disorder\" or \"problematic behavior.\" Others think over-reliance on a smartphone can become a behavioral addiction, like gambling.\u003c/p>\n\u003cp>\"It's a spectrum disorder,\" says Dr. Anna Lembke, a \u003ca href=\"https://profiles.stanford.edu/anna-lembke\" target=\"_blank\" rel=\"noopener\">psychiatrist\u003c/a> at Stanford University, who studies addiction. \"There are mild, moderate and extreme forms.\" And for many people, there's no problem at all.\u003c/p>\n\u003cp>In this way, the phone is kind of like alcohol, Lembke says. Moderate alcohol consumption can be beneficial, for some people.\u003c/p>\n\u003cp>\"You can make an argument that a temperate amount of smartphone or screen use might be good for people,\" Lembke says. \"So I'm not saying, 'Everybody get rid of their smartphones because they're completely addictive,' But instead, let's be very thoughtful about how we're how we're using these devices, because we can use them in pathological ways.\"\u003c/p>\n\u003cp>Signs you might be experiencing problematic use, Lembke says, include these:\u003c/p>\n\u003cul>\n\u003cli>Interacting with the device keeps you up late or otherwise interferes with your sleep.\u003c/li>\n\u003cli>It reduces the time you have to be with friends or family.\u003c/li>\n\u003cli>It interferes with your ability to finish work or homework.\u003c/li>\n\u003cli>It causes you to be rude, even subconsciously. \"For instance,\" Lembke asks, \"are you in the middle of having a conversation with someone and just dropping down and scrolling through your phone?\" That's a bad sign.\u003c/li>\n\u003cli>It's squelching your creativity. \"I think that's really what people don't realize with their smartphone usage,\" Lembke says. \"It can really deprive you of a kind of seamless flow of creative thought that generates from your own brain.\"\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>Consider a digital detox one day a week\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.letitripple.org/about/tiffany-shlain/\" target=\"_blank\" rel=\"noopener\">Tiffany Shlain\u003c/a>, a San Francisco Bay Area filmmaker, noticed some of those warning signs in herself and loved ones, so she and her family now power down all their devices every Friday evening, for a 24-hour period.[contextly_sidebar id=\"oKMoZqJxDnKRySnPIdhx72Nu1HStqOIa\"]\u003c/p>\n\u003cp>\"It's something we look forward to each week,\" Shlain says. She and her husband \u003ca href=\"http://goldberg.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">Ken Goldberg\u003c/a>, a professor in the field of robotics at the University of California, Berkeley, are very tech savvy. But they find they need a break.\u003c/p>\n\u003cp>\"During the week, [we're] like an emotional pinball machine responding to all the external forces,\" Shlain says. The buzzes, beeps, emails, alerts and notifications never end.\u003c/p>\n\u003cp>Shutting the smartphones off shuts out all those distractions.\u003c/p>\n\u003cp>\"You're making your time sacred again — reclaiming it,\" Shlain says. \"You stop all the noise.\"\u003c/p>\n\u003cp>When they started the digital break, which they call \"Tech Shabbat,\" Saturdays suddenly felt very different. The family's not religious, she says, but they love the Jewish Sabbath ritual of setting aside a day for rest or restoration.\u003c/p>\n\u003cp>\"The days felt much longer, and we generally feel much more relaxed,\" says Goldberg.\u003c/p>\n\u003cp>Their daughter, Odessa Shlain Goldberg, a ninth-grader, says the unplugging takes some of the pressure off.\u003c/p>\n\u003cp>\"There's no FOMO — fear of missing out — or seeing what my friends are doing,\" Odessa says. \"It's a family day.\"\u003c/p>\n\u003cp>The teen says the perspective she gains from the digital power-down carries over into the rest of the week. For instance, she thinks about using social media differently. She realizes the social-media feeds often make other people's lives appear more exciting or glamorous.\u003c/p>\n\u003cp>\"If you're sitting at home scrolling, you're not having that glamorous experience,\" she says. \"So it feels a little discouraging.\"\u003c/p>\n\u003cp>\u003cstrong>Smartphones can compound teen angst, but there's a sweet spot\u003c/strong>\u003c/p>\n\u003cp>Odessa is definitely not alone in those observations. Social media can amplify the anxieties that come along with adolescence.\u003c/p>\n\u003cp>A recent study of high school students, \u003ca href=\"http://psycnet.apa.org/record/2018-02758-001\" target=\"_blank\" rel=\"noopener\">published\u003c/a> in the journal \u003cem>Emotion\u003c/em>, found that too much time spent on digital devices is linked to lower self-esteem and a decrease in well-being. The survey asked teens how much time they spent — outside of schoolwork — on activities such as texting, gaming, searching the internet or using social media.\u003c/p>\n\u003cp>\"We found teens who spend five or more hours a day online are twice as likely to say they're unhappy,\" compared to those who spend less time plugged in, explains the study's author, \u003ca href=\"http://www.psychology.sdsu.edu/people/jean-twenge/\" target=\"_blank\" rel=\"noopener\">Jean Twenge\u003c/a>, a professor of psychology at San Diego State University.\u003c/p>\n\u003cp>Twenge's research suggests digital abstinence is not good either. Teens who have no access to screens or social media may feel shut out, she says.\u003c/p>\n\u003cp>But there may be a sweet spot. According to the survey data, \"the teens who spend a little time — an hour or two hours a day [on their devices] — those are actually the happiest teens,\" Twenge says.\u003c/p>\n\u003cp>At its best, technology connects us to new ideas and people. It makes the world smaller, and opens up possibilities.\u003c/p>\n\u003cp>\"The ability to connect with people across the world is one the great benefits,\" Odessa believes. She says she's made some of her friends \"purely online.\"\u003c/p>\n\u003cp>\"We need to wrestle with it more,\" her mother says.\u003c/p>\n\u003cp>Technology is not going away — our lives are becoming more wired all the time. But Shlain and Odessa say taking a weekly break helps their whole family find a happy medium in dealing with their phones.\u003c/p>\n\u003cp>Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\">http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Tiny+Pulse+Of+Electricity+Can+Help+The+Brain+Form+Lasting+Memories&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If the Russian psychologist Ivan Pavlov were alive today, what would he say about smartphones? He might not think of them as phones at all, but instead as remarkable tools for understanding how technology can manipulate our brains.\u003c/p>\n\u003cp>Pavlov's own findings — from \u003ca href=\"https://www.nobelprize.org/educational/medicine/pavlov/readmore.html\" target=\"_blank\" rel=\"noopener\">experiments\u003c/a> he did more than a century ago, involving food, buzzers and slobbering dogs — offer key insights, into why our phones have become almost an extension of our bodies, modern researchers say. The findings also provide clues to how we can break our dependence.\u003c/p>\n\u003cp>Pavlov originally set off to study canine digestion. But one day, he noticed something peculiar while feeding his dogs. If he played a sound — like a metronome or buzzer — before mealtimes, eventually the sound started to have a special meaning for the animals. It meant food was coming! The dogs actually started drooling when they heard the sound, even if no food was around.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Hearing the buzzer had become pleasurable.\u003c/p>\n\u003cp>That's exactly what's happening with smartphones, says David Greenfield, a \u003ca href=\"http://virtual-addiction.com/about-us/\" target=\"_blank\" rel=\"noopener\">psychologist\u003c/a> and assistant clinical professor of psychiatry at the University of Connecticut.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When we hear a ding or little ditty alerting us to a new text, email or Facebook post, cells in our brains likely release dopamine — one of the chemical transmitters in the brain's reward circuitry. That dopamine makes us feel pleasure, Greenfield says.\u003c/p>\n\u003cp>\"That ping is telling us there is some type of reward there, waiting for us,\" Greenfield says.\u003c/p>\n\u003cp>Over time, that ping can become more powerful than the reward itself. Research on animals suggests dopamine levels in the brain can be twice as high when you anticipate the reward as when you actually receive it.\u003c/p>\n\u003cp>In other words, just hearing the notification can be more pleasurable than the text, email or tweet. \"Smartphone notifications have turned us all into Pavlov's dogs,\" Greenfield says.\u003c/p>\n\u003cp>\u003cstrong>Signs you might need to cut back\u003c/strong>\u003c/p>\n\u003cp>The average adult checks their phone 50 to 300 times each day, Greenfield says. And smartphones use psychological tricks that encourage our continued high usage — some of the same tricks slot machines use to hook gamblers.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"For example, every time you look at your phone, you don't know what you're going to find — how relevant or desirable a message is going to be,\" Greenfield says. \"So you keep checking it over and over again because every once in a while, there's something good there.\" (This is called a variable ratio schedule of reinforcement. Animal studies suggest it makes dopamine skyrocket in the brain's reward circuity and is possibly one reason people keep playing slot machines.)\u003c/p>\n\u003cp>A growing number of doctors and psychologists are concerned about our relationship with the phone. There's a debate about what to call the problem. Some say \"disorder\" or \"problematic behavior.\" Others think over-reliance on a smartphone can become a behavioral addiction, like gambling.\u003c/p>\n\u003cp>\"It's a spectrum disorder,\" says Dr. Anna Lembke, a \u003ca href=\"https://profiles.stanford.edu/anna-lembke\" target=\"_blank\" rel=\"noopener\">psychiatrist\u003c/a> at Stanford University, who studies addiction. \"There are mild, moderate and extreme forms.\" And for many people, there's no problem at all.\u003c/p>\n\u003cp>In this way, the phone is kind of like alcohol, Lembke says. Moderate alcohol consumption can be beneficial, for some people.\u003c/p>\n\u003cp>\"You can make an argument that a temperate amount of smartphone or screen use might be good for people,\" Lembke says. \"So I'm not saying, 'Everybody get rid of their smartphones because they're completely addictive,' But instead, let's be very thoughtful about how we're how we're using these devices, because we can use them in pathological ways.\"\u003c/p>\n\u003cp>Signs you might be experiencing problematic use, Lembke says, include these:\u003c/p>\n\u003cul>\n\u003cli>Interacting with the device keeps you up late or otherwise interferes with your sleep.\u003c/li>\n\u003cli>It reduces the time you have to be with friends or family.\u003c/li>\n\u003cli>It interferes with your ability to finish work or homework.\u003c/li>\n\u003cli>It causes you to be rude, even subconsciously. \"For instance,\" Lembke asks, \"are you in the middle of having a conversation with someone and just dropping down and scrolling through your phone?\" That's a bad sign.\u003c/li>\n\u003cli>It's squelching your creativity. \"I think that's really what people don't realize with their smartphone usage,\" Lembke says. \"It can really deprive you of a kind of seamless flow of creative thought that generates from your own brain.\"\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>Consider a digital detox one day a week\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.letitripple.org/about/tiffany-shlain/\" target=\"_blank\" rel=\"noopener\">Tiffany Shlain\u003c/a>, a San Francisco Bay Area filmmaker, noticed some of those warning signs in herself and loved ones, so she and her family now power down all their devices every Friday evening, for a 24-hour period.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"It's something we look forward to each week,\" Shlain says. She and her husband \u003ca href=\"http://goldberg.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">Ken Goldberg\u003c/a>, a professor in the field of robotics at the University of California, Berkeley, are very tech savvy. But they find they need a break.\u003c/p>\n\u003cp>\"During the week, [we're] like an emotional pinball machine responding to all the external forces,\" Shlain says. The buzzes, beeps, emails, alerts and notifications never end.\u003c/p>\n\u003cp>Shutting the smartphones off shuts out all those distractions.\u003c/p>\n\u003cp>\"You're making your time sacred again — reclaiming it,\" Shlain says. \"You stop all the noise.\"\u003c/p>\n\u003cp>When they started the digital break, which they call \"Tech Shabbat,\" Saturdays suddenly felt very different. The family's not religious, she says, but they love the Jewish Sabbath ritual of setting aside a day for rest or restoration.\u003c/p>\n\u003cp>\"The days felt much longer, and we generally feel much more relaxed,\" says Goldberg.\u003c/p>\n\u003cp>Their daughter, Odessa Shlain Goldberg, a ninth-grader, says the unplugging takes some of the pressure off.\u003c/p>\n\u003cp>\"There's no FOMO — fear of missing out — or seeing what my friends are doing,\" Odessa says. \"It's a family day.\"\u003c/p>\n\u003cp>The teen says the perspective she gains from the digital power-down carries over into the rest of the week. For instance, she thinks about using social media differently. She realizes the social-media feeds often make other people's lives appear more exciting or glamorous.\u003c/p>\n\u003cp>\"If you're sitting at home scrolling, you're not having that glamorous experience,\" she says. \"So it feels a little discouraging.\"\u003c/p>\n\u003cp>\u003cstrong>Smartphones can compound teen angst, but there's a sweet spot\u003c/strong>\u003c/p>\n\u003cp>Odessa is definitely not alone in those observations. Social media can amplify the anxieties that come along with adolescence.\u003c/p>\n\u003cp>A recent study of high school students, \u003ca href=\"http://psycnet.apa.org/record/2018-02758-001\" target=\"_blank\" rel=\"noopener\">published\u003c/a> in the journal \u003cem>Emotion\u003c/em>, found that too much time spent on digital devices is linked to lower self-esteem and a decrease in well-being. The survey asked teens how much time they spent — outside of schoolwork — on activities such as texting, gaming, searching the internet or using social media.\u003c/p>\n\u003cp>\"We found teens who spend five or more hours a day online are twice as likely to say they're unhappy,\" compared to those who spend less time plugged in, explains the study's author, \u003ca href=\"http://www.psychology.sdsu.edu/people/jean-twenge/\" target=\"_blank\" rel=\"noopener\">Jean Twenge\u003c/a>, a professor of psychology at San Diego State University.\u003c/p>\n\u003cp>Twenge's research suggests digital abstinence is not good either. Teens who have no access to screens or social media may feel shut out, she says.\u003c/p>\n\u003cp>But there may be a sweet spot. According to the survey data, \"the teens who spend a little time — an hour or two hours a day [on their devices] — those are actually the happiest teens,\" Twenge says.\u003c/p>\n\u003cp>At its best, technology connects us to new ideas and people. It makes the world smaller, and opens up possibilities.\u003c/p>\n\u003cp>\"The ability to connect with people across the world is one the great benefits,\" Odessa believes. She says she's made some of her friends \"purely online.\"\u003c/p>\n\u003cp>\"We need to wrestle with it more,\" her mother says.\u003c/p>\n\u003cp>Technology is not going away — our lives are becoming more wired all the time. But Shlain and Odessa say taking a weekly break helps their whole family find a happy medium in dealing with their phones.\u003c/p>\n\u003cp>Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\">http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Tiny+Pulse+Of+Electricity+Can+Help+The+Brain+Form+Lasting+Memories&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Kate Bowler's new memoir, \u003cem>Everything Happens for a Reason And Other Lies I've Loved\u003c/em>, is a funny, intimate portrait of living in that nether space between life and death. In it, she shares her experiences with incurable stage 4 cancer and gives advice on what not to say to those who are terminally ill.\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>3 things not say to someone terminally ill, from author Kate Bowler...\n\u003cli>'Everything happens for a reason.'\u003c/li>\u003cli>'How are the treatments going?'\n\u003c/li>\u003cli>How are you really?\u003c/li>\u003c/ul>\n\u003c/aside>\n\u003cp>Bowler is also the host of\u003ca href=\"https://www.npr.org/podcasts/583447646/everything-happens\" target=\"_blank\" rel=\"noopener\"> Everything Happens\u003c/a>, a new podcast.\u003c/p>\n\u003cp>She writes that sometimes silence is the best response: \"The truth is that no one knows what to say. It's awkward. Pain is awkward. Tragedy is awkward. People's weird, suffering bodies are awkward. But take the advice of one man, who wrote to me with his policy: Show up and shut up.\"\u003c/p>\n\u003cp>\u003cstrong>Interview Highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On why she wrote Everything Happens For A Reason\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Suddenly at [age] 35, I get this stage 4 cancer diagnosis, and it's just like a bomb went off and everything around me is debris. And I'm thinking, \"Oh my gosh, did I actually maybe expect that everything was going to work out for me?\" And so I wrote the book more like a theological excavation project, like I was just trying to get down to the studs of what I really expected from my life. And I think I was a lot more sure than I realized ... maybe that I was the architect of my own life, that I could overcome anything with a little pluck and determination.\u003c/p>\n\u003cp>\u003cstrong>On how a cancer diagnosis changed her outlook on life\u003c/strong>\u003c/p>\n\u003cp>I kind of pictured my life like it was this life enhancement project, and like my life is like a bucket and I'm supposed to put all the things in the bucket. And the whole purpose is to figure out how to have as many good things coexisting at the same time.And then when everything falls apart, you totally have to switch imagination, like maybe instead, life is just vine to vine. And you're like grabbing onto something, and you're just hoping for dear life it doesn't break.\u003c/p>\n\u003cp>\u003cstrong>On how that diagnosis affected her relationship to friends and family\u003c/strong>\u003c/p>\n\u003cp>I went from feeling like a normal person to all of a sudden, like this spaghetti bowl of cancer. I was trying to learn how to give up really quickly, like looking at my beautiful husband and just immediately all the stuff you're supposed to say, which is just like, \"I have loved you forever,\" and \"All I want for you is love.\"\u003c/p>\n\u003cp>... You have these impossible thoughts like, \"You will live without me,\" and \"Please take care of our kid.\" And like you're trying to do all that hard work and then in the same moment, they're trying to rush in and say, \"We're going to fight this.\" There's all these plans they want to pour their certainty in, to remake the foundation. And there's this, kind of, almost terrible exchange, where you're trying to remake the world as it was. But it's all come apart.\u003c/p>\n\u003cp>\u003cstrong>On whether she has had conversations with her 4-year-old son about death\u003c/strong>\u003c/p>\n\u003cp>He is entirely impervious to all of this, in the best way. But I do think the thing that has radically changed is I really was, before, trying to create this little bubble around him and us, 'cause I thought, like, \"It's my job to protect you,\" and then I realized that I would be the worst thing that happened to him if this went badly.\u003c/p>\n\u003cp>So then I thought like, \"OK, parenting strategy change.\" And I thought, 'Well, if I can just teach you that there is still beauty in others in the midst of pain, then like, that's my job.\" So we work a lot on like, \"How are you feeling?\" like, \"I feel frustrated.\" And then getting him to notice the feelings of others.\u003c/p>\n\u003cp>\u003cstrong>On how she has learned to cope with negative news about her diagnosis\u003c/strong>\u003c/p>\n\u003cp>Well I have rules for when things are too sad, 'cause sometimes, just the reality of things really feels like an avalanche, and it's just going to sweep everything away. So I do make rules for the day, like don't talk about sad things after 9 p.m., so I try to make my day a little gentler. I try to make other people's day a little gentler. The other thing I do is I try really stupid stuff, like I got terrible news a couple months ago, which thankfully turned out to be a medical error.\u003c/p>\n\u003cp>It was a scan and it looked brutal, but I spent that week thinking like, \"This is my last year for sure.\" And it was weird because the next day, I turned to a friend and I said, \"Would you like to go visit the world's largest Ukrainian sausage?\" And he was like, \"Oh, I'm in.\"\u003c/p>\n\u003cp>\u003cstrong>On her list of things not to say to someone with terminal cancer, including \"How are the treatments going and how are you really?\" [book excerpt]\u003c/strong>\u003c/p>\n\u003cp>This is the toughest one of all. I can hear you trying to be in my world and be on my side. But picture the worst thing that's ever happened to you. Got it? Now try to put it in a sentence. Now say it aloud 50 times a day. Does your head hurt? Do you feel sad? Me too. So let's just see if I want to talk about it today, because sometimes I do and sometimes I want a hug and a recap of American Ninja Warrior.\u003c/p>\n\u003cp>\u003cem>Jeffrey Pierre and Miranda Kennedy produced and edited this interview for broadcast. Sydnee Monday and April Fulton adapted it for the Web.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\">http://www.npr.org/\u003c/a>.\u003c/p>\n\n",
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
"airtime": "SUN 9pm-10pm",
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"meta": {
"site": "radio",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.commonwealthclub.org/podcasts",
"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
"title": "Freakonomics Radio",
"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
}
},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"id": "here-and-now",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/hiddenbrain.jpg",
"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
"site": "news",
"source": "NPR"
},
"link": "/radio/program/hidden-brain",
"subscribe": {
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"tuneIn": "https://tunein.com/podcasts/Science-Podcasts/Hidden-Brain-p787503/",
"rss": "https://feeds.npr.org/510308/podcast.xml"
}
},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"rss": "https://feeds.npr.org/510313/podcast.xml"
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
"imageAlt": "KQED Hyphenación",
"officialWebsiteLink": "/podcasts/hyphenacion",
"meta": {
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"amazon": "https://music.amazon.com/podcasts/6c3dd23c-93fb-4aab-97ba-1725fa6315f1/hyphenaci%C3%B3n",
"rss": "https://feeds.megaphone.fm/KQINC2275451163"
}
},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/xtTd",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
"site": "news",
"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/id73801135",
"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Political Breakdown",
"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
"site": "radio",
"source": "kqed",
"order": 5
},
"link": "/podcasts/politicalbreakdown",
"subscribe": {
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
"npr": "https://www.npr.org/podcasts/572155894/political-breakdown",
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